Note: The job is a remote job and is open to candidates in USA. MedWatch, LLC is seeking a Bilingual Concierge Customer Service Representative who will provide exceptional customer service by addressing inquiries in both Spanish and English. The role requires strong interpersonal skills and the ability to handle complex customer interactions effectively.
Responsibilities
- Respond to telephone and email inquiries received from members and provider within defined service standards
- Negotiate with providers to gain acceptance for plans without network agreements and/or out of network providers
- Assist members with benefits and healthcare questions
- Document all calls received in system-based call log
- The incumbent may be responsible for duties or responsibilities that are not listed in this job description. Duties and responsibilities may change at any time with or without notice
Skills
- Minimum High School Diploma or G.E.D
- Customer Service / Call Center experience
- Strong customer relations, interpersonal skills
- Strong appreciation and ability to handle confidential & sensitive information
- Individual must speak fluent English and Spanish with strong reading and writing abilities in each language
- Proficient with Microsoft applications and computer navigation
- Knowledge of provider organizations and networks
- Knowledge and understanding of CMS Medicare reimbursement rates
- Ability to effectively negotiate rate structures
- Patience and ability to handle difficult situations tactfully and diplomatically
- Takes initiative to resolve situations and to accomplish projects actions and tasks
- Excellent verbal and written communication skills
- Independent judgment in decision making and problem solving
- Ability to multi-task & anticipate potential needs/problems
- Ability to build relationships with internal and external customers
- Strong attention to detail
- Strong computer skills
- Strong analytical and research skills
- Good organizational skills and time management
- Effective problem solving and decision-making skills
- Associate degree or higher preferred but not required
- Understanding of Self-Funded health benefits a plus
- Health Payor background preferable in self-funded industry a plus
- Claim processing skills a plus
- Insurance verification or pre-certification a plus
- Provider office/facility billing department or financial area
- TPA experience a plus
- Strong computer skills with proficiency in MS Office Suite products (Word, Excel, PowerPoint)
Company Overview
Since 1988, MedWatch has been a leader in providing concierge member advocacy and medical cost containment solutions for TPAs, employer groups, school systems, municipalities, hospital systems, Taft-Hartley plans, and fully insured payers as well as for the reinsurance industry and stop loss carriers. It was founded in 1988, and is headquartered in Lake Mary, Florida, USA, with a workforce of 201-500 employees. Its website is https://www.urmedwatch.com/home/.
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