Bilingual Customer Service Representative
Job Summary
This is a volume-driven customer service and production-based role responsible for managing daily activities within the health insurance operations. The position involves handling member and provider interactions via multiple channels while strictly adhering to standard operating procedures. You will manage assigned caseloads and collaborate with various partners to ensure service quality and compliance.
Responsibilities
- Manage member and provider inquiries via multiple channels
- Maintain caseload productivity and quality standards
- Escalate and resolve operational issues
- Ensure compliance with PHI and regulatory standards
Required Skills
- Bilingual (Spanish/English) fluency
- 1+ years customer service experience
- 6+ months healthcare experience
- Data entry and analytical skills
Job Details
Responsibilities:
- Develop a comprehensive understanding of the current processes, procedures, and tools associated with the Oscar business model.
- Work with members, brokers, providers, and Oscar vendors through multiple channels according to assignment needs.
- Manage an assigned caseload, maintaining service delivery, productivity, and quality expectations.
- Form working relationships with all partners.
- Support the leadership team by identifying issues through established escalation pathways.
- Monitor and track the health of all assigned work-in-progress issues.
- Escalate and resolve issues to ensure appropriate turnaround times.
- Participate in process improvement projects.
- Comply with all operational, regulatory, and compliance standards relating to member Personal Health Information (PHI).
- Compliance with all applicable laws and regulations.
- Other duties as assigned.
Requirements:
- Must be bilingual in Spanish and English with full professional proficiency in reading, writing, and speaking.
- 1+ years of experience in a high-volume or customer-focused setting.
- 6+ months of healthcare experience.
- High school diploma or GED.
Bonus points:
- Strong quantitative or analytical skills focused on solving problems.
- Experience manipulating and entering accurate data.
- Advanced Google Suite or Microsoft Office capabilities.