BILINGUAL PROVIDER SERVICES REPRESENTATIVE - CALL CENTER

TPIS•Guaynabo, PR

1d•$0 - $13•Onsite

About The Position

Our client in the healthcare industry is seeking a Bilingual Provider Services Representative to assist healthcare providers, including physician offices and clinics, through inbound telephone calls and live chat. The selected candidate will provide information and support regarding member eligibility, benefits, claims, billing and payments, treatment authorizations, and explanations of benefits. This position requires strong customer service, problem-solving, and computer navigation skills, along with the ability to communicate professionally in English and Spanish. This opportunity is ideal for someone with healthcare and customer service experience who enjoys solving problems, navigating multiple systems, and building positive relationships with healthcare providers and their staff.

Requirements

At least one year of customer service experience analyzing and resolving customer concerns; or at least one year of experience in an office, administrative, or clerical environment using the telephone and computer as primary work tools.
Previous healthcare experience is required.
Professional proficiency in English and Spanish.
Intermediate or advanced proficiency using Microsoft and Windows PC applications.
Ability to navigate, learn, and work efficiently across multiple complex computer systems.
Strong verbal communication, active-listening, and problem-solving skills.
Ability to explain information clearly and professionally to healthcare providers.
Strong attention to detail and ability to document information accurately.
Ability to work in a fast-paced call center environment and manage multiple priorities.

Responsibilities

Answer incoming calls from healthcare providers, including physician offices and clinics.
Identify each provider's needs and offer assistance related to benefits, eligibility, claims, billing, payments, treatment authorizations, and explanations of benefits.
Provide customer service support through live chat, including updates regarding member eligibility and claim status.
Review and validate state-specific requirements related to claims and benefits processing.
Navigate multiple computer systems and applications to research provider inquiries.
Focus on resolving questions and concerns during the first interaction whenever possible.
Deliver clear, accurate, and professional information to providers and their staff.
Build positive working relationships through courteous and solutions-focused service.
Document provider inquiries, actions taken, and outcomes accurately in company systems.
Help identify and report recurring provider concerns and service trends.
Meet established expectations for service quality, productivity, accuracy, and attendance.
Perform other related duties as assigned.