CarePlus Medicare Call Center Rep - Puerto Rico

Humana

6d • Remote

About The Position

Become a part of our caring community and help us put health first The Medicare Call Center Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries from Medicare members. The Medicare Call Center Representative 2 performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. The Medicare Call Center Representative 2 addresses customer needs which may include complex benefit questions, resolving issues, and educating members. Records details of inquiries, comments or complaints, transactions or interactions and takes action accordingly. Escalates unresolved and pending customer grievances. Decisions are typically focused on interpretation of area / department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization / timing, and works under minimal direction. Follows standard policies / practices that allow for some opportunity for interpretation / deviation and / or independent discretion. Handles 20 to 35 inbound calls daily from Medicare members with a focus on high-quality service and one-call resolution. While the associate receives inbound calls, 60% to 70% of them require associates to place outbound calls to physicians, DME vendors, pharmacies or other entities to help members. Records details of inquiries, comments or complaints, transactions, or interactions, and takes action accordingly. Escalates unresolved and pending customer grievances. Decisions are typically focused on interpretation of area / department policy and methods for completing assignments. Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Follows standard policies / practices that allow for some opportunity for interpretation/deviation and / or independent discretion. Requires strong emotional intelligence to proactively provide solutions, ensuring the member's utmost health and safety. Use your skills to make an impact

Requirements

• Must currently live in the Commonwealth of Puerto Rico.
• Must be fully Bilingual in English / Spanish with the ability to speak, read, and write in both languages without limitations or assistance.
• If selected for the position, you will be required to take a Language Proficiency Assessment in English / Spanish (see Language Proficiency Testing below).
• 1+ years of customer service experience
• Demonstrated experience with providing strong customer service and attention to detail while actively listening.
• Prior experience managing multiple or competing priorities, including use of multiple computer applications / systems simultaneously.
• Proficiency with Microsoft Office applications, particularly Outlook and Teams
• Ability to maintain a professional demeanor, practicing strict confidentiality for all sensitive information.
• Strong initiative with the ability to adapt to change quickly and be empathetic.
• Must have the ability to provide a high-speed DSL or cable modem for a home office. A download speed of 25 Mbps and an upload speed of 10 Mbps is required.
• Associates in this role are required to be hard-wired to their internet connection. Wireless, satellite, cellular, and microwave connections are NOT permitted.
• Must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
• You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities.

Nice To Haves

• Associate or Bachelor’s degree
• Previous call center or related customer service experience
• Previous experience with case management processes
• Previous healthcare experience

Responsibilities

• Addresses customer needs which may include complex benefit questions, resolving issues, and educating members.
• Records details of inquiries, comments or complaints, transactions or interactions and takes action accordingly.
• Escalates unresolved and pending customer grievances.
• Handles 20 to 35 inbound calls daily from Medicare members with a focus on high-quality service and one-call resolution.
• Places outbound calls to physicians, DME vendors, pharmacies or other entities to help members.

Benefits

• Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees