Bilingual Commercial Health Call Center Representative (Healthcare)

TL;DR

Bilingual Commercial Health Call Center Representative (Healthcare): Managing inbound and outbound inquiries regarding commercial health plan benefits, eligibility, and claims with an accent on member and provider satisfaction. Focus on resolving complex billing and claim issues, coordinating with internal departments, and ensuring high-quality documentation in a virtual environment.

Location: Remote (Must be based in the United States in the CST or EST time zone)

Company

hirify.global is the major medical division of Globe Life, focused on bringing a personalized, human approach to high-technology health insurance.

What you will do

• Handle inbound and outbound calls and email inquiries from members and providers.
• Research and respond to inquiries regarding commercial health plan benefits, eligibility, and claims.
• Manage escalations and member complaints, ensuring timely and professional closure.
• Coordinate with internal departments, vendors, and business partners to solve problems.
• Document all interactions accurately and identify trends to suggest process improvements.
• Assist members in using the member portal to increase self-sufficiency.

Requirements

• Must reside and work within the United States in the CST or EST time zone.
• Fluency in both English and Spanish is required.
• Minimum of 2 years of customer service experience supporting commercial health plans (excluding Medicare/Medicaid only).
• Knowledge of medical insurance terminology including CPT/ICD-10, HCPCS, and Revenue Codes.
• Proficiency in Microsoft Office and experience with CRM systems, preferably Salesforce.
• Ability to maintain a secure, dedicated home office environment with high-speed internet.

Culture & Benefits

• Comprehensive health, dental, and vision insurance, including life and disability.
• Retirement savings plan with company match.
• Generous paid time off and vacation.
• Professional development opportunities.
• Fully remote and flexible work environment.