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Driscoll Health Plan - Bilingual Customer Service Representative

Company: Driscoll Children's Hospital
Location: Mcallen
Posted on: January 16, 2022

Job Description:

General Purpose of Job:The Bilingual Customer Service Representative is responsible for the assisting Member/ Provider with healthcare inquires concerns, or complaints via telephone.Essential Duties and Responsibilities:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This job description is not intended to be all-inclusive; employees will perform other reasonably related business duties as assigned by the immediate supervisor and/or health plan administration, as required.General Duties:

  • Respond to member/provider inquiries via telephone regarding health insurance benefits, eligibility and claims.
  • Analyze problems and provide correct information and solutions.
  • Communicate monthly messages to providers on a specific needs basis.
  • Deal tactfully and empathetically with customers.
  • Establish and maintain effective working relationships with physician office staff.
  • Read, comprehend and verbalize processes and procedures of the organization and of health insurance coverage.
  • Multi-task and pay close attention to detail.Education and/or Experience:
    • Minimum of a high school diploma or equivalent
    • Prior experience in Customer Service in a Managed Care Organization preferred
    • Ability to type a minimum of 35 words per minute
    • Knowledge of managed care processes and health insurance coverage preferred
    • Outstanding communication skills and the ability to understand complex situations to effectively handle escalated customer needs
    • Analytical skills and the ability to read and interpret data
    • Problem solving abilities
    • Ability to work independently and as a part of a team
    • Ability to operate computer programs - Microsoft Word, Microsoft Excel, Microsoft PowerPoint
    • Must be Bilingual in Spanish
      Ind123Classification:Full-time Regular (72+ hrs/pp)Work Schedule:Days

Keywords: Driscoll Children's Hospital, McAllen , Driscoll Health Plan - Bilingual Customer Service Representative, Healthcare , Mcallen, Texas

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