US Remote Healthcare Call Center Representative (Spanish Bilingual)

VXI Global Solutions; Richmond (VA); Remote; USD 22,000 - 33,000; Full time

Benefits offered by this job

Competitive pay

Medical, dental, and vision benefits

Growth opportunities

Inclusive workplace

Cell phone allowance

Referral program

Job summary

Trusted Leader in Healthcare Services is seeking a Spanish-English bilingual Healthcare Call Center Representative. You will assist members, providers, and patients in both languages, recording inquiries and guiding them through benefits, networks, and coverage policies.

This remote role requires strong communication, problem solving, and HIPAA compliance. Two years in healthcare/CS and a high school diploma are preferred, with opportunities for growth and development within the company.

Qualifications

• Fluency in Spanish and English is required.
• At least two years in customer service or healthcare member interaction.
• Call center experience or health insurance industry preferred.

Responsibilities

• Handle inquiries from members, providers, and patients in Spanish and English.
• Document queries and resolve issues while complying with HIPAA regulations.
• Explain health plan benefits, provider networks, and coverage policies clearly.
• Navigate CRM/EMR/EHR and ticketing platforms to record interactions.
• Meet call center KPIs such as first call resolution and member retention.
• Uphold privacy and confidentiality of member information.

Skills

Bilingual Spanish-English

Communication skills

Typing 35 WPM

Problem solving

Education

High School Diploma or GED

Tools

CRM/EMR/EHR systems

Job description

Spanish Bilingual Healthcare Call Center Representative

Company: Trusted Leader in Healthcare Services

Are you fluent in both Spanish and English? Do you have a passion for delivering exceptional customer service and helping others navigate their healthcare options? If so, we want to hear from you!

As a Spanish Bilingual Healthcare Call Center Representative, you will be the cornerstone of our commitment to customer satisfaction. In this role, you will provide comprehensive support and information to members, providers, and patients, ensuring they maximize the benefits of their healthcare plans and services. By adhering to compliance guidelines and embodying our company values, you will deliver extraordinary service while building trust and rapport with current and prospective members.

What You’ll Be Doing:

Customer Interactions:

• Manage inquiries in areas such as Member Services, Medicare, and Billing, assisting Spanish- and English-speaking customers.
• Represent our client professionally by addressing and documenting all incoming queries, including complex calls related to specialized product lines.

Quality Service:

• Uphold the organization’s philosophy of extraordinary customer relations.
• Proactively engage with Health Plan, medical group, and facility personnel to gather relevant information for resolving member inquiries.

Problem Resolution:

• Analyze and evaluate customer issues to initiate and coordinate service recovery measures.
• Document all member interactions meticulously following established procedures.
• Demonstrate familiarity with health insurance terminology (copays, deductibles, claims, authorizations, etc.).
• Understand Medicare/Medicaid plans and regulations, and explain plan benefits, provider networks, and coverage policies.

Operational Excellence

• Leverage a thorough understanding of company policies and processes to meet customer needs effectively.
• Contribute to departmental goals and objectives while maintaining proficiency through ongoing training and use of required tools.

Performance Metrics:

• Monitor and achieve Contact Center KPIs, including call handling, first call resolution, and member retention.

Compliance and Ethics:

• Consistently uphold company compliance standards and Code of Conduct, ensuring privacy and confidentiality of member information.
• Adhere to HIPAA regulations to protect personal health information (PHI) and maintain data security.

Tools and Systems:

• Use multiple systems/screens while assisting callers effectively
• Navigate CRM, EMR/EHR, and ticketing platforms effectively

What You Bring:

Experience:

• Fluency in both Spanish and English (spoken and written) is required.
• Minimum of two (2) years of customer service or healthcare member-interaction experience.
• Previous call center experience and/or prior experience in the health insurance industry (preferred).

Education:

• High School Diploma or GED required.

Skills:

• Outstanding written and verbal communication skills.
• Proven analytical and problem-solving abilities.
• Ability to respond concisely and clearly to customer queries.
• Strong critical thinking and problem-solving skills.
• Typing speed of at least 35 WPM with a 5% or lower error rate.

Success Factors for Working from Home

• To thrive in this remote role, you’ll need:
• Private Workspace: A dedicated, quiet workspace with a door that closes, free from ambient noise.
• Ergonomics: A comfortable desk and chair setup that allows for the proper installation of necessary equipment.
• Reliable Internet Connection: Stable, high-speed internet with a minimum bandwidth of 20 Mbps downstream and 20 Mbps upstream.
• Quiet, Distraction-Free Workspace: A dedicated, quiet area where you can focus on delivering excellent customer service without interruptions.
• Tech-Savvy: Comfort with technology and ability to learn new systems quickly.
• Self-motivation & Independence: Ability to stay productive and manage your time effectively in a remote environment.
• Communication Skills: Strong verbal and written communication skills, especially in a virtual setting.
• Adaptability: Ability to adapt to changing technologies and procedures while working remotely.

What You Will Get:

• Competitive Pay: Enjoy a competitive hourly rate with opportunities for performance-based increases.
• Comprehensive Benefits: Full health insurance coverage, including medical, dental, and vision plans.
• Work Environment: A supportive, engaging, and inclusive work environment with opportunities to grow and develop your skills.
• Career Growth: Abundant advancement opportunities within the organization.
• Inclusive Workplace: We are an Equal Opportunity Employer, welcoming individuals with disabilities and veterans.
• Cell Phone Benefits: $25/month per line for unlimited phone, text, and data (restrictions may apply).
• Referral for Life Program™: Earn residual bonuses for referring employees who join the team and remain with the company.

Join Our Team:

If you are a motivated Spanish-English bilingual professional who wants to make a meaningful impact in the lives of others, we encourage you to apply! Start a rewarding career where your language skills, dedication, and customer service expertise will help shape the future of healthcare services.

If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!