[Remote] Bilingual Customer Service Representative (April)

Note: The job is a remote job and is open to candidates in USA. Brighton Health Plan Solutions is committed to improving healthcare access and delivery. The Customer Service Representative assists members and healthcare providers with inquiries related to member benefits, eligibility, and claims while ensuring customer satisfaction through effective communication and problem-solving.ResponsibilitiesHandle inbound calls from members, medical providers, and othersAdjust claims accurately, if neededListen to and address customer needs and concerns empatheticallyAnswer questions about fee schedules, network participation, and requirementsEnsure first contact resolution when possibleUpdate customer files and communicate effectively with teamsTransfer misdirected requests and offer solutions to non-routine issuesContribute to customer satisfaction and business improvementUse decision-support tools to provide accurate responsesInvestigate inquiries using training and systemsAdapt responses to caller understandingEducate callers and validate their understandingSupport projects and other departments as directed by managementSkillsExperience in a high-volume call centerExperience with claims inquiry and claims review proceduresKnowledge of medical specialties, fee schedules, complaints and appeals, and call center responsibilitiesPrevious experience in a physician's office, group practice, clinic or hospital-based practicesFluent in both English and SpanishHigh School diploma with some college or business school education preferredBasic computer operations knowledgeIntermediate proficiency in Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)Strong time management skillsGeneral knowledge of HIPAA Confidentiality lawsQuick learner with ability to grasp managed care procedures and claims payment policiesDetail-oriented and dependableEffective listening and responding skillsFlexible and adaptable to changes, with conceptual thinkingStrong problem-solving abilitiesExcellent attendance and punctualityComfortable performing tasks at a computer/telephone stationEffective communication through various channels, including email, chat, and voicePrevious multi-channel experience is a plusCompany OverviewBrighton Health Plan Solutions is a health care company that specializes in health plan management service. It was founded in 2016, and is headquartered in New York, New York, USA, with a workforce of 201-500 employees. Its website is https://brightonhps.com.



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