Bilingual Commercial Health Call Center Representative (Spanish)

TL;DR

Bilingual Commercial Health Call Center Representative (Customer Support): Providing comprehensive support for commercial health plan members and providers with an accent on benefit eligibility, claims interpretation, and complaint resolution. Focus on delivering exceptional service while maintaining high accuracy in documentation and adherence to industry-specific billing guidelines.

Location: Must be based in the United States in the CST or EST time zone.

Company

hirify.global is a high-technology health insurance provider and a division of Globe Life, dedicated to increasing transparency and access to personalized healthcare.

What you will do

• Research and resolve inquiries from members and providers regarding benefits, eligibility, and claims.
• Manage escalations with a sense of urgency and professional communication.
• Interpret and explain complex billing guidelines, CPT/ICD-10 codes, and claim payments.
• Document all interactions accurately within the CRM system.
• Collaborate with internal departments like Claims and Medical Management to solve member issues.
• Participate in team huddles and supervisor check-ins within a virtual environment.

Requirements

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

Culture & Benefits

• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company match.
• Generous paid time off and vacation policy.
• Professional development and growth opportunities.
• Fully remote work environment with a focus on human-centric health insurance.