Bilingual Customer Service Representative - Dalton, United States - Alliant Health Plans

Alliant Health Plans Dalton, United States

3 weeks ago

Description

Bilingual Customer Service Representative

Description **Job Purpose**

The Bilingual Customer Service Representative addresses inquiries, questions and concerns in all areas including enrollment, eligibility, claims, benefit interpretation, and referrals/authorizations for medical care. The position is responsible for receiving, responding to, and directing member, broker and provider phone calls and other communications and provides available information upon request and escalates issues as appropriate. The Bilingual Customer Service Representative will be fluent in both Spanish and English.

Requirements **Duties and Responsibilities**

Receives customer calls or inquiries, which include potential/current/previous members, brokers and providers, and routes appropriately

Provides timely and accurate information to customers

Processes customer requests according to established department policies and procedures

Completes research and investigative activities to address customer inquiries

Works closely with other departments to gather information

Provides timely feedback to customers through outbound calling, email, mail or fax

Provides timely feedback to the company regarding service failures, systemic issues or customer concerns

Assists in the completion of special projects

Assists in the documentation, evaluation and revision of department policies and procedures

Meets or exceeds service level agreements in call center metrics

Attends and participates in meetings and trainings as required

Regular and predictable attendance

Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice

Maintains work area in a clean and orderly condition and ensures safe operating conditions within area of responsibility

Works to encourage and promote Company culture throughout the organization

Other duties as may be assigned

**Qualifications**

Requires a high school diploma or its equivalent

Related experience preferred

Bilingual in Spanish and English

Confidentiality and time management skills

Ability to learn quickly and be self-motivated

Knowledge of healthcare billing and claims preferred

Insurance experience preferred

**Competencies**

**Ethics** Honest, accountable, maintains confidentiality

**Reliability** The extent to which the employee can be depended upon to be available for work, do it properly, and complete it on time. The degree to which the employee is reliable, trustworthy, and persistent.

**Sense of Urgency** Meets deadlines, establishes appropriate priority, gets the job done in a timely manner

**Customer Service** Works will with customers, promotes a positive image of the company, strives to solve issues raised by customers

**Skills** Possesses effective communication skills: oral, written, listening

**Computer Skills** Skilled with computers, takes advantage of new technology, learns new tools quickly, uses technology to enhance job performance

**Conflict Management** Good listener, committed to finding solution to problems, works well with difficult people

**Cooperation** Willingness to work harmoniously with others in getting a job done. Readiness to respond positively to instructions and materials.

**Initiative** Takes action, seeks new opportunities, strives to see projects to completion

**Job Knowledge** Knowledge of products, policies and procedures; OR knowledge of techniques, skills, equipment, procedures, and materials

**Organizational Skills** Information organized and accessible, maintains efficient workspace, manages time well

**Problem Solving** Displays ability to recognize a problem, trouble shoots to ascertain the extent of the problem, and selects appropriate alternative to investigate or resolve the problem

**Physical, Mental, Environmental & Working Conditions**

Significant amount of sitting and typing. Moderate amount of walking and writing. Moderate to significant amount of stress in meeting deadlines and dealing with day-to-day events in the execution of job duties. Needs flexibility and adaptability to change. Candidate must be self-disciplined and a self-starter and able to work independently with a flexible work schedule.

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