Bilingual (Spanish) Commercial Health Call Center Representative (Healthcare)

TL;DR

Bilingual Commercial Health Call Center Representative (Healthcare): Managing member and provider inquiries regarding commercial health plan benefits, eligibility, and claims with an accent on bilingual communication and accuracy. Focus on resolving complex claims issues, managing escalations, and ensuring high-quality customer service within the US healthcare insurance domain.

Location: Must live and work in the United States within the CST or EST time zones

Company

hirify.global is the major medical division of Globe Life, focused on providing personalized and transparent health insurance plans.

What you will do

• Handle inbound and outbound calls and emails from members and providers regarding benefits and eligibility.
• Provide accurate information on commercial health plan benefits and claims processing.
• Manage escalations, handle member complaints, and process appeals professionally.
• Coordinate problem-solving with internal departments, vendors, and business partners.
• Document all interactions accurately and identify trends to suggest process improvements.
• Assist members in navigating the member portal to increase their self-sufficiency.

Requirements

• Must live and work in the United States within the CST or EST time zones.
• Fluency in both English and Spanish is required.
• Minimum of 2 years of customer service experience supporting a commercial health plan (excluding Medicare/Medicaid only).
• Knowledge of medical insurance terminology, including CPT/ICD-10, HCPCS, and Revenue Codes.
• Proficiency in Microsoft Office and experience using a CRM, preferably Salesforce.
• Access to a dedicated, private work area with a high-speed internet connection.

Culture & Benefits

• Competitive salary and comprehensive health, dental, and vision insurance.
• Retirement savings plan with company match.
• Generous paid time off and vacation.
• Professional development opportunities.
• Flexible, fully remote work environment.