Job Description

Spanish Bi-lingual Member Services Representative II

Atlantic City, NJ

4 weeks of paid onsite training, remote from there with the exception of every 7 weeks, required to be in-office for 1 week.

This is for a stellar organization with amazing benefits (almost no cost), people, culture, stability and growth!

The Spanish Bi-lingual Member Services Representative provides members with benefit, eligibility, claim and health care education, information, and issue resolution to this multi-cultural community.

DUTIES

• Serves as the main point of contact for the members, unions, employers, providers, and vendors on benefit, claims and eligibility issues, education, and questions
• Receives and records telephone inquiries regarding plan benefits, claims and eligibility
• Performs telephonic enrollment functions and in-person outreach as needed
• Encourages members to take steps to get involved in programs to improve their health
• Recognizes and communicates issues to management including trends and anomalies
• Research benefit, eligibility and claim issues and initiates corrective action with relevant departments
• Maintains up-to-date knowledge of all systems and sources relating to plan benefits, processes, policies, etc. that will affect performance of daily tasks
• Seeks management assistance on issues unable to resolve in a timely manner
• Maintains awareness of work volumes and service levels

MUST HAVE:

• Spanish bi-lingual skill (spoken)
• 1-2 years of previous call center experience is a must!
• Experience in customer service duties in person and/or over the phone

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