Remote Customer Service Rep (Bilingual in Spanish)
Core
Remote Regional Concierge Navigator providing outreach, support, and navigation for seniors and chronically ill members through healthcare and benefits.
Role type
Senior IC customer service navigator (healthcare)
Builds
Coordinated care access and member engagement for seniors and chronically ill individuals
Domain
Healthcare / Medicare Advantage / HMO
Deliverable
client delivery
Required skills
ICD-10 and CPT codes knowledge, Medicare Advantage/HMO navigation, authorizations and referrals, provider appointment scheduling, medical records retrieval, high-volume inbound support, bilingual communication (English/Spanish)
Preferred skills
Telemarketing, member outreach, escalation resolution, high-volume health plan experience
Technologies
None explicitly stated
Responsibilities
Conduct member onboarding and welcome calls, resolve member issues and case follow-ups, coordinate care access with PCPs and specialists, assist with authorizations and referrals, place appointment reminders and confirmations, communicate member updates to providers, handle eligibility and benefits inquiries, conduct in-person member engagement activities
Seniority
Entry-level to Mid-level, hands-on IC