SKYGEN USA

Compensation

Full Description

Important things YOU should know: • Must be fluent in Spanish • Fully remote opportunity • Training schedule: 8:00am- 4:30pm CST Monday – Friday • Work schedule (after training): 8:00am – 4:30pm CST Monday - Friday • Hours of operation: 7:00am - 8:00pm CST so shift could flex based on business need • Occasional evenings, weekends and holidays possible during Annual Medicare Open Enrollment: 10/1 - 3/31 • $2.00/hour differential on Mon/Tues • Exceptional professional growth in a fun rewarding environment What will YOU be doing for us? Our Customer Service Representatives must have strong problem-solving skills, coupled with the natural ability to provide empathy for the customer – always taking the time to patiently listen and understand their questions to help find a viable solution, while providing them with a memorable customer experience. What is in it for YOU? • Career growth in an inclusive culture • Paid training • Health benefits • 401(k) What will YOU be working on every day? • Servicing our Dental and Vision callers with information regarding their eligibility, benefit coverage, authorizations, claims, and assisting them with locating a provider in their area, • Utilize knowledge of claim adjustments and resubmission processes to determine appropriate resolution to provider requests. • Provide feedback to Provider Relations staff on high-level claim issues including but not limited to issues with reimbursement schedules or conflicting information to ensure providers receive a prompt resolution. • Support enrollment activities including but not limited to assigning primary care providers, and updating third party insurance information. • Act as liaison between our organization and the client’s Member Services staff to resolve issues such as eligibility and filing appeals and grievances. • Provide updates to providers with questions regarding the status of their credentialing application. • Recognize provider questions that could be handled through the use of the provider web portal and provide education to these callers on the benefits of utilizing the technology available. • Ensure all calls are answered according to company and client guidelines. • Accurately document call information and resolution in our internal systems. • Apply effective diffusion techniques when necessary to ensure our customers feel heard, valued and supported. • Properly identify issues that need to be escalated appropriately to the leadership team. Additional Responsibilities: • Provide recommendations on system enhancements and process improvements to management. • Keep our Provider Relations team updated with provider manual discrepancies, change in locations or any other provider related issues. • Participate in departmental projects when applicable. What qualifications do YOU need to have to be GOOD candidate? Required Level of Education, Licenses, and/or Certificates • High school diploma or equivalent Required Level of Experience • 1+ years of job related customer service experience within industries such as healthcare, call center, banking or retail Required Knowledge, Skills, and Abilities • Must be fluent in Spanish • Basic knowledge of Microsoft Office products including but not limited to Word, Excel, and Outlook • Ability to work occasional overtime as needed • Excellent listening and communication skills • Superior customer service skills including the natural ability to provide empathy • Strong data entry/typing skills • Strong navigation skills and the ability to multi-task • Excellent attention to detail • Critical thinking skills to quickly analyze and clearly understand a specific request or customer need • Leverage knowledge and resources to provide the appropriate solutions What qualifications do YOU need to be a GREAT candidate? Preferred Level of Experience • 1+ years of job related customer service experience within the dental, vision or medical industry • Previous experience working in a virtual environment • Understanding of dental, vision and/or medical insurance terminology • Previous call center experience