Representante de Servicio al Cliente I: Soluciones Rápidas

MCS Health; Guayama (PR); On-site; USD 32,000 - 52,000; Full time

Job summary

MCS Healthcare Holdings, LLC is seeking a Customer Service Representative I – SC in Puerto Rico to assist members and providers with health plan information, benefits, and services. You will resolve routine inquiries and document service interactions to ensure accuracy and continuity of coverage.

The role involves handling calls, CRM case logging, and escalation when needed, requiring bilingual communication in Spanish and English and a focus on service quality, policy adherence, and regulatory

Qualifications

• Bachelor’s Degree or equivalent college credits with health insurance Call Center experience.
• 60-64 college credits (two years) with at least 1 year in Customer Service in health insurance.
• High School Diploma with 2 years of health insurance customer service experience is acceptable when proven.

Responsibilities

• Handle and resolve service requests from customers and prospects about policyholders' eligibility, letters of non-covered services, and billing.
• Log cases in CRM, keep customers informed, and document steps taken.
• Answer calls from the Call Center, resolve complex benefit questions, and ensure follow-up when needed.
• Refer complaints to the appropriate unit and support other departments with service requests.
• Adhere to all company policies, procedures, and applicable laws.

Skills

Customer service

Communication

CRM

Documentation

Education

Bachelor’s Degree

60-64 college credits

Associate’s Degree

Job description

MCS Healthcare Holdings, LLC is seeking a Customer Service Representative I – SC in Puerto Rico to assist members and providers with health plan information, benefits, and services. You will resolve routine inquiries and document service interactions to ensure accuracy and continuity of coverage.

The role involves handling calls, CRM case logging, and escalation when needed, requiring bilingual communication in Spanish and English and a focus on service quality, policy adherence, and regulatory