Hybrid Customer Service Representative

at TeleMedik

• Job title: Customer Service Representative
• Job type: Full Time
• Experience level: Junior
• Salary: $12 - $13 per hour
• Degree requirement: High School Diploma
• Location requirements: Hybrid, Guaynabo, United States

About the role

• Customer Service Representative responsible for assisting clients with their health insurance inquiries via telephone. Ensuring excellence in service and compliance with regulations while documenting all interactions.

Responsibilities

• Communicates with members by phone to provide information about their respective health insurance plan services.
• Offers guidance, support, and educational services on non-clinical matters related to the different plan coverages and promotions.
• Manages incoming calls and refers them to the appropriate resources based on the member’s specific needs.
• Documents and records transactions, including details of inquiries and actions taken.
• Refers unresolved customer complaints to a supervisor or designated departments for further investigation.
• Supports other Contact Center projects.
• Conducts outbound phone interviews with members regarding services, satisfaction levels, and follow-up activities.
• Participates in training and development sessions.
• Ensures confidentiality and compliance with all applicable state and federal health call center regulations, including HIPAA and internal policies for handling confidential information.
• Immediately reports any Protected Health Information (PHI) exposure to the supervisor.
• Complies with core and functional trainings, as well as all procedures established by regulatory agencies, contractual requirements, and applicable certification standards (including but not limited to URAC).

Requirements

• Minimum of one (1) year of experience in Customer Service.
• Completed high school and/or university credits (preferred).
• Advanced knowledge of computer applications and/or Microsoft Office.
• Strong customer service orientation and commitment.
• Excellent verbal and written communication skills.
• Fast documentation and internet navigation skills.
• Availability for rotating shifts (including weekends/holidays), Monday to Sunday from 7:00 a.m. to 7:00 p.m.

Benefits

• Training in service, regulatory aspects, and healthcare.
• 24/7 Telemedicine service.
• Free employee health and wellness programs.
• Opportunities for growth and development.
• Contributing to the health and well-being of the population.
• Paid leave benefits.