LATAM Customer Service Representative

LOOKING FOR LATIN AMERICABASED CANDIDATES

Position: Virtual Assistant / Customer Service Representative
Working Hours: MF 8:00 am4:30 pm 9:00 am5:30 pm or 10:30 am – 7:00 pm EST
Salary Range:USD / Monthly



ABOUT THE COMPANY

This company works with local health plans to provide regionally informed humanistic coverage and care to a rapidly expanding community in need. They advance patientcentered healthcare and reduce the cost of caring for underserved and complex populations.


ABOUT THE ROLE

As a Customer Service Representative for ACO Reach you will provide beneficiaries beneficiary family members and/or advocates providers and community service organizations with the information to ensure that they receive supportive services equipment and supplies needed to promote quality of life and the achievement of beneficiary identified desired outcomes. The Customer Service Representative will empower the members to make informed decisions provide benefit information and advocate on their behalf when deemed necessary.


DUTIES AND RESPONSIBILITIES:

• Answer inbound calls from beneficiaries with questions about claims benefits eligibility and prior authorizations.
• Conduct outbound calls to orient new members to the Belong Health ACO Reach program and assist with care coordination.
• Collaborate with providers social workers discharge planners and communitybased service providers to coordinate care and achieve care plan goals.
• Facilitate and monitor the implementation of the member care plan in accordance with recommendations by the Interdisciplinary Care Team.
• Identify the nature of issues independently respond to and resolve nonclinical issues and complaints and escalate clinical issues to appropriate department and staff.
• Work with members providers and staff to identify and resolve member service and retentionrelated issues.
• Educate potential members/community representatives on plan features plan benefits and program admission requirements.
• Promote a culture of accountability and performance to both meet and exceed personal service vision goals and ensure timely and satisfactory resolution of highly complex specialized and nonroutine customer issues.
• Additional duties assigned.

SKILLS AND REQUIREMENTS:

• 2 years’ experience in care coordination customer service health care organization Community Based Organization or social services environment.
• Working knowledge of Medicare and Medicaid programs and experience with regulatory requirements and reporting.
• Demonstrated experience in a managed care or HMO setting is strongly preferred.
• Knowledge of managed care and/or member services.
• Familiarity with coordinated care models is an advantage.
• Understanding of the needs and dynamics of elder care services disadvantaged and disengaged populations.
• Excellent problemsolving trend identification and analytical skills with a demonstrated ability to problemsolve effectively and efficiently.
• Commitment to high ethical standards in all work; protects the privacy of member and Belong data and exercises discretion in handling confidential member information.
• Excellent oral and written communication skills.
• Demonstrated PC skills using Microsoft applications.
• Knowledge of managed care product portfolio benefits policies and procedures.
• Strong active listening issue assessment and problemsolving skills.
• Strong organizational and followthrough skills.
• REQUIRED: Spanish Speaking

Please note: We prioritize processing one application at a time. If you have applied for multiple job openings within our organization we kindly request that you direct any update inquiries to the team responsible for handling your initial application.