Client Services Coordinator 2

Carolina, Puerto Rico APS Health Care PR

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Position Summary:

The Client Services Coordinator 2 / G&A provides outstanding customer service. This key individual communicates with a wide variety of external contacts including members, providers, facilities, as well as clinical and operational staff. The Client Services Coordinator assesses the needs of internal and external clients in a timely and efficient manner, thus resulting in optimum operational performance. The Client Services Coordinator 2 is fully dedicated to duties of the Quality Department. This employee is not responsible for conducting any UM review activities that require interpretation of clinical information.

Essential Functions:

  1. Complies with all guidelines established by the Centers for Medicare and Medicaid (CMS) and guidelines set forth by other regulatory agencies, where applicable.
  2. Recognizes customer needs to assist in a complaint, grievances, or appeals.
  3. Receives, prepares, and manages a complaint, grievances, or appeal file.
  4. Maintains a record of grievances and appeals utilizing various documentation operating systems.
  5. Conducts investigations to resolve complaints, grievances, and appeals.
  6. Maintains database by entering information related to the department. Sends letters to beneficiaries and facilities when the regulations are applicable.
  7. Monitors and complies with the period to send notifications to the beneficiaries and the facility.
  8. Use of clinical data is limited to: Performance of review of service request for completeness of information; Collection and transfer of non-clinical data; and Acquisition of structured clinical data; and Activities that do not require evaluation or interpretation of clinical information.
  9. In addition, all other duties assigned by the manager and/or supervisor.


Education:

  • High School Diploma required.
  • Bachelor’s degree preferred

Experience:

  • Minimum 2 years of experience in a customer service position.

Knowledge: ·

  • Personal computer experience should include working with Microsoft Word, Excel, Power Point and Outlook at the intermediate level at a minimum.

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Pharmacy Help Desk Call Center Representative

Guaynabo, Puerto Rico Pharmpix

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POSITION SUMMARY

The Pharmacy Help Desk Call Center Representative reports to the Pharmacy Help Desk Call Center Supervisor and is responsible to provide a customer service by telephone of incoming and outbound calls to providers, beneficiaries and pharmacies.

ESSENTIALS ROLES AND RESPONSIBILITIES

1. Answer incoming pharmacy calls regarding issues related to a claim transaction, reimbursement, payment, and other required information in accordance with PharmPix Pharmacy Help Desk Call Center performance metrics.

2. Answer incoming providers’ and beneficiaries’ calls following Call Center scripts, in a timely matter and in accordance with PharmPix call center performance metrics.

3. Answer incoming calls and perform outbound calls according to HIPAA and Pharmacy Laws Standards.

4. Identify pharmacies, providers and beneficiaries needs, clarify information, research every issue and providing solutions.

5. Document all inquiries in the Customer Service Management Applications such as, Service Desk, OneArk and email.

6. Route the case to the corresponding internal department or the appropriate Health Insurance Carrier.

7. Guide pharmacies, providers and beneficiaries regarding the process of claim

transmission, reimbursement and payment.

8. Constantly monitors the BACMAN Alert Application to ensure proper management of rejections at point of sale.

9. Evaluate on an individual basis to determine if the patient meets the criteria for a coverage determination for alerts such as DURs (Drug Utilization Reviews), HMO (Health Maintenance Organization) among other rejections evaluations required by business.

10. Identify system issues and route to the corresponding internal department.

11. Make outbound calls to pharmacies, providers and beneficiaries if necessary.

12. Support all Quality Management Program initiatives.

13. Perform Special projects and/or other duties assigned by the Operations Manager and or Pharmacy Help Desk Call Center Supervisor.

TRAINING & EDUCATION

Pharmacy Technician, Technical or Associate Degree

LICENSURE / CERTIFICATION

Puerto Rico Board of Pharmacy Technician Registry Certificate (CPhT), or prospect.

PROFESSIONAL EXPERIENCE

1 - 2-year customer service or call center experience and healthcare environment (Preferable).

PROFESSIONAL COMPETENCIES

Knowledge:

• Fully Bilingual (Spanish / English written and verbal).

• PC skills (Microsoft System)/System oriented.

Skills:

• Strong customer service skills.

• Excellent phone, written, active listening and follow-through skills.

• Skill in analyzing situations accurately and taking effective action.

• Attention to details.

• Time Management Skills: Establishing priorities and accomplishing tasks in a timely manner.

• Ability to work with others to reach a solution.

• Be able to toggle between several software programs.

• Demonstrated effective organizational skills.

Abilities:

• Able to effectively interact with internal departments, PharmPix clients, members and other healthcare professionals.

• Ability to work with others to reach a solution.

• Be able to toggle between several software programs.

• Ability to work in a fast-paced environment and multitask.


PharmPix is an Equal Employment Opportunity Employer Minorities / Females / Disable / Veterans

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CALL CENTER REPRESENTATIVE

Catano, Puerto Rico Able Sales Company Inc

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¡ÚNETE A NUESTRO EQUIPO EN ABLE SALES!


Vacante: Representante de Servicio al Cliente (CALL CENTER) - Presencial a Tiempo Completo

Ubicación: Cataño,Puerto Rico


¿Quiénes somos?

En Able Sales , líder en la manufactura y distribución de azúcar en Puerto Rico, nos enorgullece liderar nuestra marca principal "Dulce Ca ñ a ".


¿Qué buscamos?

Estamos buscando un(a) Representante de Servicio al Cliente que desempeñe un papel fundamental en el servicio y manejo de cuentas importantes en la empresa.


Lo que buscamos en ti:

  • Experiencia en Servicio al Cliente
  • Excelente comunicación verbal y escrita.
  • Dominio de Microsoft.
  • Experiencia en ORACLE (preferiblemente)
  • Disponibilidad lunes a viernes 8:00am a 5:00pm.


Responsabilidades:

  • Gestionar un gran número de llamadas entrantes.
  • Generar oportunidades de venta.
  • Identificar y evaluar las necesidades de los clientes para lograr su satisfacción.
  • Crear relaciones sostenibles y confianza con las cuentas de clientes mediante una comunicación honesta e interactiva.
  • Proporcionar información precisa, válida y completa usando los métodos y herramientas correctos.
  • Cumplir los objetivos de ventas personales/del equipo de atención al cliente y las cuotas de gestión de llamadas.
  • Atender las quejas de clientes, ofrecer soluciones y alternativas adecuadas dentro de los plazos, y realizar un seguimiento para garantizar la resolución.
  • Llevar un registro de las interacciones con clientes, procesar cuentas de clientes y archivar documentos.
  • Seguir procedimientos de comunicación, directrices y políticas.
  • Facturación y control de documentos.
  • Trabajar en colaboración con otros departamentos según las necesidades de los mismos.
  • Todas aquellas responsabilidades que surjan según la necesidad de Able Sales.


Lo que ofrecemos:

  • Un equipo dinámico
  • Beneficios marginales
  • Plan Médico
  • 401k
  • Incentivos
  • Bonos

¿Estás listo para ser parte de nuestro equipo? Envía tu resume y únete a la familia de Dulce Ca ñ a .

¡Esperamos contar contigo para seguir innovando y creciendo juntos!



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CALL CENTER ASSOCIATE

Guaynabo, Puerto Rico Alivia Health

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Job Description

The Call Center Specialist is an office-based position that plays a key role in patient and provider customer service. The Call Center Specialist is the first point of contact for Alivia Specialty Pharmacy customers. The Call Center Specialist ensure patient satisfaction through personal attention, and an efficient, transparent and simple process from end to end.

Call Center Specialists answer and document In Bound calls. They must answer questions and inquiries, troubleshoot problems, provide information and handle complaints regarding the organization’s products or services. Call Center Specialists may be required to make outbound calls to follow up with patients and HCP offices.

Responsibilities include, but are not limited to:

  • Answering phones from customers professionally and responding to customer inquiries.
  • Routing inbound calls to the appropriate resources.
  • Following up complicated customer calls where required.
  • Researching required information using available resources.
  • Handling and resolving customer complaints.
  • Identifying, escalating priority issues and reporting to the high-level management.
  • Completing detailed and specific call notes as necessary, updating them in CPR+.
  • Obtaining documenting and reporting relevant data to handle complaints and inquiries.
  • Managing administration, communicating and coordinating with internal departments.
  • Meet management’s production standards, whether quantitative or qualitative
  • Other analogous duties may be assigned from time to time as needed by Alivia.

Minimum requirements:

  • Great communicator at all levels, including but not limited to physicians, office staff, patients and their caregivers;
  • Able to work effectively in team matrixes with limited supervision;
  • High School Diploma required, Pharmacy Technician Associate’s Degree preferred;

***EEOC F/M/D/V***

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CALL CENTER ASSOCIATE

Guaynabo, Puerto Rico Alivia Health

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Job Description

Job Description

Job Description

The Call Center Specialist is an office-based position that plays a key role in patient and provider customer service. The Call Center Specialist is the first point of contact for Alivia Specialty Pharmacy customers. The Call Center Specialist ensure patient satisfaction through personal attention, and an efficient, transparent and simple process from end to end.

Call Center Specialists answer and document In Bound calls. They must answer questions and inquiries, troubleshoot problems, provide information and handle complaints regarding the organization’s products or services. Call Center Specialists may be required to make outbound calls to follow up with patients and HCP offices.

Responsibilities include, but are not limited to:

  • Answering phones from customers professionally and responding to customer inquiries.
  • Routing inbound calls to the appropriate resources.
  • Following up complicated customer calls where required.
  • Researching required information using available resources.
  • Handling and resolving customer complaints.
  • Identifying, escalating priority issues and reporting to the high-level management.
  • Completing detailed and specific call notes as necessary, updating them in CPR+.
  • Obtaining documenting and reporting relevant data to handle complaints and inquiries.
  • Managing administration, communicating and coordinating with internal departments.
  • Meet management’s production standards, whether quantitative or qualitative
  • Other analogous duties may be assigned from time to time as needed by Alivia.

Minimum requirements:

  • Great communicator at all levels, including but not limited to physicians, office staff, patients and their caregivers;
  • Able to work effectively in team matrixes with limited supervision;
  • High School Diploma required, Pharmacy Technician Associate’s Degree preferred;

***EEOC F/M/D/V***

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Providers Call Center Representative

00918 San Juan, Puerto Rico Adecco US, Inc.

Posted 4 days ago

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Adecco is assisting a local client recruiting for Providers Call Center Representative opportunities in San Juan, PR. This is an excellent opportunity to join a winning culture and get your foot in the door with a company that offers onsite, bilingual customer service roles supporting the healthcare industry. If Providers Call Center Representative sounds like something you would be interested in, and you meet the qualifications listed below, apply now!
Responsibilities for a Customer Service Representative in clude but are not limited to:
- Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type of assistance the provider needs (EG. benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits)
- Provides customer service support to providers through live chat, to give updates on their member's eligibility status or claims status and validates state specific requirements for claims and benefits processing.
- Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller
- Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff
- Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends
Preferred Qualifications:
- 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
- Microsoft and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
- Bilingual Spanish/English proficiency
What's in this Customer Service Representative position for you?
- Pay: $ 13.00/hour.
- Shift: between 8:00 AM - 9:00 PM, Monday-Friday (8-hour shifts).
- Work Model: Onsite.
- Weekly paycheck.
- Dedicated Onboarding Specialist & Recruiter.
- Access to Adecco's Aspire Academy with thousands of free upskilling courses.
This Providers Call Center Representative position is being recruited for by one of our Centralized Delivery Team and not your local branch. For instant consideration for this position and other opportunities with Adecco, apply today!
**Pay Details:** $13.00 per hour
Benefit offerings available for our associates include short-term disability and additional voluntary benefits including medical, dental, vision, life insurance, commuter benefits and a 401K plan.
Our benefit offerings provide employees the flexibility to choose the type of coverage that meets their individual needs. In addition, our associates may be eligible for paid leave including Paid Sick Leave and Vacation Leave or any other paid leave required by Federal, State, or local law where applicable.
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to Company will consider qualified applicants with arrest and conviction records in accordance with federal, state, and local laws and/or security clearance requirements, including, as applicable:
+ The California Fair Chance Act
+ Los Angeles City Fair Chance Ordinance
+ Los Angeles County Fair Chance Ordinance for Employers
+ San Francisco Fair Chance Ordinance
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Remote Call Center Representative - Puerto Rico

00968 Guaynabo, Puerto Rico Conduent

Posted 9 days ago

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Job Description

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
**Remote Customer Service Representative - Puerto Rico**
**Must be proficient in English.**
**Must reside in Puerto Rico to be considered.**
Are you passionate about helping others and delivering exceptional service? Join our dynamic team where you become the first point of contact for our client's customers. With paid training, competitive pay at **$11/hr** , and a range of incentives and benefits, you'll be empowered to make a real impact every day.
**What We Offer:**
+ **Work From Home**
+ **Full-Time Employment:** Reliable schedule and stability.
+ **Competitive Pay:** Earn $1/hr with shift differentials- 1.10 extra per hour for shifts between 6 PM-6 AM, and/or 1.00 extra per hour on weekends.
+ **Paid Training & Overtime:** Get the training you need to excel and take advantage of overtime opportunities.
+ **Incentive Plan:** Potential to earn up to an additional 350 per month after training by meeting performance metrics.
+ **Career Growth:** Opportunities to advance your career in a supportive, innovative environment.
+ **Full Benefits:** Comprehensive benefit options and a great work environment that values your success.
**What You'll Do:**
+ Efficiently manage a high volume of inbound calls in a fast-paced environment.
+ Access cardholder accounts to provide information about payments and benefits deposited by state or federal agencies.
+ Assist cardholders with inquiries regarding transactions and account statuses.
+ Listen actively to understand customer needs and offer clear, accurate information.
+ Process transactions efficiently via web-based applications and handle research requests with precision.
+ Maintain in-depth knowledge of company and client programs, policies, and technology.
+ Communicate in a warm, empathetic manner while ensuring confidentiality and compliance with all regulations.
+ Support team operations during peak times or absences to help maintain seamless service.
**What We're Looking For:**
+ An effective communicator who can clearly explain complex information.
+ A dedicated professional with a strong work ethic and problem-solving skills.
+ A customer service enthusiast who excels in navigating multiple screens and applications while guiding customers to the best solution.
+ Ready to commit to 100% attendance during our three-to-five-week paid training period.
**Requirements:**
+ Must be at least 18 years old and possess a High School Diploma or equivalent.
+ Must have 6 months of Customer Service, Call Center or Dispatch experience.
+ Proficient in English.
+ Complete a background check, credit check, and security fingerprinting.
+ **Internet Service:** Must have a verified, secure, reliable, and high-speed internet connection to support business needs.
+ **Work Area** : Must have an established, dedicated work area equipped with a desk, chair, electrical outlet, and direct LAN connection.
+ **Equipment:** The company will provide all necessary computer equipment
+ **Internet Speed Test:** Must complete an internet speed test and achieve a minimum of **50 Mbps upload and 20 Mbps download** .
+ Reside in Puerto Rico with legal authorization to work permanently in the United States.
**Preferred Qualification:**
+ 1+ years of previous call center experience
Take the next step in your career and join a team that values quality service and continuous growth. Apply today to become a vital part of our customer service team in Guaynabo!
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate for this role is 11.00 per hour.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form ( . Complete the form and then email it as an attachment to . You may also click here to access Conduent's ADAAA Accommodation Policy ( .
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Remote Call Center Representative - Puerto Rico

00968 Guaynabo, Puerto Rico Conduent

Posted 9 days ago

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Job Description

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
**Remote Customer Service Representative - Puerto Rico**
**Must be proficient in English.**
**Must reside in Puerto Rico to be considered.**
Are you passionate about helping others and delivering exceptional service? Join our dynamic team where you become the first point of contact for our client's customers. With paid training, competitive pay at **$11/hr** , and a range of incentives and benefits, you'll be empowered to make a real impact every day.
**What We Offer:**
+ **Work From Home**
+ **Full-Time Employment:** Reliable schedule and stability.
+ **Competitive Pay:** Earn $1/hr with shift differentials- 1.10 extra per hour for shifts between 6 PM-6 AM, and/or 1.00 extra per hour on weekends.
+ **Paid Training & Overtime:** Get the training you need to excel and take advantage of overtime opportunities.
+ **Incentive Plan:** Potential to earn up to an additional 350 per month after training by meeting performance metrics.
+ **Career Growth:** Opportunities to advance your career in a supportive, innovative environment.
+ **Full Benefits:** Comprehensive benefit options and a great work environment that values your success.
**What You'll Do:**
+ Efficiently manage a high volume of inbound calls in a fast-paced environment.
+ Access cardholder accounts to provide information about payments and benefits deposited by state or federal agencies.
+ Assist cardholders with inquiries regarding transactions and account statuses.
+ Listen actively to understand customer needs and offer clear, accurate information.
+ Process transactions efficiently via web-based applications and handle research requests with precision.
+ Maintain in-depth knowledge of company and client programs, policies, and technology.
+ Communicate in a warm, empathetic manner while ensuring confidentiality and compliance with all regulations.
+ Support team operations during peak times or absences to help maintain seamless service.
**What We're Looking For:**
+ An effective communicator who can clearly explain complex information.
+ A dedicated professional with a strong work ethic and problem-solving skills.
+ A customer service enthusiast who excels in navigating multiple screens and applications while guiding customers to the best solution.
+ Ready to commit to 100% attendance during our three-to-five-week paid training period.
**Requirements:**
+ Must be at least 18 years old and possess a High School Diploma or equivalent.
+ Must have 6 months of Customer Service, Call Center or Dispatch experience.
+ Proficient in English.
+ Complete a background check, credit check, and security fingerprinting.
+ **Internet Service:** Must have a verified, secure, reliable, and high-speed internet connection to support business needs.
+ **Work Area** : Must have an established, dedicated work area equipped with a desk, chair, electrical outlet, and direct LAN connection.
+ **Equipment:** The company will provide all necessary computer equipment
+ **Internet Speed Test:** Must complete an internet speed test and achieve a minimum of **50 Mbps upload and 20 Mbps download** .
+ Reside in Puerto Rico with legal authorization to work permanently in the United States.
**Preferred Qualification:**
+ 1+ years of previous call center experience
Take the next step in your career and join a team that values quality service and continuous growth. Apply today to become a vital part of our customer service team in Guaynabo!
Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate for this role is 11.00 per hour.
Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.
For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form ( . Complete the form and then email it as an attachment to . You may also click here to access Conduent's ADAAA Accommodation Policy ( .
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Patient Access - Call Center Representative (Remote)

Carolina, Puerto Rico Brave Health

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Job Description

Job Description

Why We're Here:
At Brave Health, we are driven by a deep commitment to transform lives by expanding access to compassionate, high-quality mental health care. By harnessing the power of technology, we break down barriers and bring mental health treatment directly to those who need it most—wherever they are. As a community health-centered organization, we are dedicated to ensuring that no one is left behind. Nearly 1 in 4 people in the U.S. receive healthcare through Medicaid, yet two-thirds of providers don’t accept it. Brave Health is stepping up to close this gap by making mental health care accessible, affordable, and life-changing for all.

Job Overview

As an Access Counselor, you will serve as the primary point of contact for patients, playing a vital role in guiding them through their healthcare journey. You will manage inbound communications from prospective and established clients as well as facilitating outbound phone calls, text messages and emails which will provide education on services, scheduling appointments, and assisting with pre-appointment form completion. By troubleshooting technical issues, verifying insurance, and maintaining accurate patient records, you will ensure a seamless experience while upholding HIPAA compliance. As the face of the organization, your focus on patient engagement, satisfaction, and timely problem resolution is essential in delivering high-quality virtual healthcare services.

Pay Rate

The starting pay rate for this position is $18.00 per hour.

Responsibilities

  • Interact with current and prospective patients to drive engagement and schedule appointments.

  • Educate patients about healthcare offerings, including services like BPS assessments and medication management.

  • Perform initial patient screenings and provide information on healthcare services.

  • Use motivational interviewing techniques to build relationships and ensure patient satisfaction.

  • Handle high volumes of inquiries and outreach follow-up via phone, text, and email related to appointment scheduling, rescheduling, and administrative matters.

  • Maximize provider schedules by efficiently scheduling appointments and reducing no-show rates.

  • Maintain patient charts by documenting demographic and insurance information and ensuring form completion.

  • Verify patient insurance eligibility and assist with troubleshooting during the virtual care process.

Qualifications

  • 1-3+ years in a full-time, patient-facing role in a healthcare setting

  • Tech-savvy, with the ability to self-teach new platforms and work across multiple systems/applications simultaneously

  • Strong communication skills, both verbal and written, with the ability to screen patients over the phone and provide accurate, satisfactory answers to queries and concerns

  • Calm and professional demeanor during all patient interactions, especially with those dealing with addiction or mental health disorders

  • High sense of urgency and the ability to independently manage time and resources to meet deadlines

  • Experience in appointment scheduling and patient communication, ensuring high attention to detail and accuracy

  • Thrives in a fast-paced, rapidly changing environment

  • Effective problem-solver, able to think quickly on your feet

  • Passion for increasing access to high-quality, affordable behavioral health care

  • Familiarity with Google, EHRs, HIPAA compliance, and 42 CFR regulations

  • Eligibility to work in the United States. We are not able to provide or assist with visas or attaining work eligibility

What We Offer 

Brave Health provides its employees a comprehensive benefits package that includes:

  • W2, Full-time hourly position

  • Monday - Friday schedule; No on-call or weekend shifts

  • Health, Dental, Vision Insurance benefits

  • Vacation, Holiday and Sick time

Brave Health is very proud of our diverse team who cares for a diverse population of patients. We are an equal opportunity employer and encourage all applicants from every background and life experience to apply.

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Call Center Provider Representative- San Juan ,PR

00918 San Juan, Puerto Rico UnitedHealth Group

Posted 3 days ago

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Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start **Caring. Connecting. Growing together.**
**Primary Responsibilities:**
+ Answer incoming phone calls from health care providers (i.e. physician offices, clinics) and identify the type of assistance the provider needs (EG. benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits)
+ Provides customer service support to providers through live chat, to give updates on their member's eligibility status or claims status and validates state specific requirements for claims and benefits processing.
+ Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller
+ Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff
+ Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends
This role is equally challenging and rewarding. It requires fluency in computer navigation and toggling while you confidently and compassionately engage in dialogue with the caller. Be assured that our training will provide you with knowledge of the various products, plans and levels of benefits available to members and you'll soon find yourself creating positive experiences and earning the gratitude of callers on an hourly basis.
***ENGLISH PROFICIENCY ASSESSMENT WILL BE REQUIRED AFTER APPLICATION***
You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
**Required Qualifications:**
+ 1+ years of experience in a related environment (i.e. office, administrative, clerical, customer service, etc.) using phones and computers as the primary job tools
+ Microsoft and Windows PC applications, which includes the ability to navigate and learn new and complex computer system applications
+ Available to work (40 hours/week) Monday- Friday. Flexible to work any of our 8 hour shift schedules during our normal business hours of (8:00am to 9:00pm ATL)
+ Bilingual Spanish/English proficiency
**Preferred Qualification:**
+ Health care experience
_At UnitedHealth Group, our mission is to help people live healthier lives and make the health system work better for everyone. We believe everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately experienced by people of color, historically marginalized groups and those with lower incomes. We are committed to mitigating our impact on the environment and enabling and delivering equitable care that addresses health disparities and improves health outcomes - an enterprise priority reflected in our mission._
_UnitedHealth Group is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national origin, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations._
_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._
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  31. emoji_events Graduate
  32. health_and_safety Healthcare
  33. beach_access Hospitality & Tourism
  34. groups Human Resources
  35. precision_manufacturing Industrial Engineering
  36. security Information Security
  37. handyman Installation & Maintenance
  38. policy Insurance
  39. code IT & Software
  40. gavel Legal
  41. sports_soccer Leisure & Sports
  42. inventory_2 Logistics & Warehousing
  43. supervisor_account Management
  44. supervisor_account Management Consultancy
  45. supervisor_account Manufacturing & Production
  46. campaign Marketing
  47. build Mechanical Engineering
  48. perm_media Media & PR
  49. local_hospital Medical
  50. local_hospital Military & Public Safety
  51. local_hospital Mining
  52. medical_services Nursing
  53. local_gas_station Oil & Gas
  54. biotech Pharmaceutical
  55. checklist_rtl Project Management
  56. shopping_bag Purchasing
  57. home_work Real Estate
  58. person_search Recruitment Consultancy
  59. store Retail
  60. point_of_sale Sales
  61. science Scientific Research & Development
  62. wifi Telecoms
  63. psychology Therapy
  64. pets Veterinary
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