Remote Bilingual Customer Service Representative
JOB SUMMARY:
This is a work from home position for Customer Service Representatives who can speak fluently in Spanish and in English. CSR's must be located in Virginia, Maryland, Pennsylvania, or DC. CSR's provide outstanding customer service related to Veteran care through the Community Care Network (CCN) in a fast-paced contact center. Responds to inbound calls and chat messages from Spanish-speaking callers regarding authorizations for medical and behavioral health care, provider status and availability, or claims payment and status. Accurately assesses caller requests, answers caller inquires and processes requests while focusing on first call resolution and/or appropriate call escalation protocols. May make outbound calls to schedule appointments based on Veteran or VA request. Resolves administrative eligibility discrepancies through account research and review.
EDUCATION & EXPERIENCE
Required
- Fluent in Spanish
- Must be eligible to work in the United States
- High School diploma or GED
- One year of experience in a customer service role with performance metrics
- Experience using Microsoft Office products and the Internet
Preferred
- Healthcare industry experience to include knowledge of health services and claims
- Contact center experience to include call center chat messaging
- Military experience focusing on service delivery
KEY RESPONSIBILITIES
- Manages multiple tasks lists in accordance with directed timelines. Meets call volume, chat volume, schedule adherence, quality, Veteran appointment, and other production standards.
- Initiates and receives phone calls, chat messages and emails from VA medical center staff, and providers to answer claims, eligibility, benefit, and program questions. In select markets, facilitates appointment scheduling of Veterans through outbound solicitation to providers. Records preferences tracks Veteran questions thoroughly in the TriWest’s Customer Relationship Management systems and Portal, as well as VA’s HSRM systems.
- Consistently displays professional and courteous service skills to internal and external customers.
- Accurately resolves VA and provider inquiries with a focus on first call resolution.
- Protects the privacy of health information of patients when using or disclosing Protected Health Information (PHI).
- Takes appropriate measures to comply with HIPAA regulations to protect privacy of customers' health information.
- Documents all communications involving Veteran and provider contacts. Uses critical thinking in problem solving and follows established processes to assure quality program compliance.
- Consistently meets department productivity and performance metrics to include regular and consistent attendance.
- Participates in cross training, employee development and flexible assignments to ensure business needs are met.
COMPETENCIES
Technical Skills
Proficient data entry skills: Ability to meet daily call and chat requirements.
Team Building / Team Player
Influence the actions and opinions of others in a positive direction and build group commitment.
Organizational Skills
Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.
Information Management
Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.
High Intensity Environment
Ability to function in a fast-paced environment with multiple activities occurring simultaneously while maintaining focus and control of workflow.
Empathy / Customer Service
Customer-focused behavior; Helping approach, including listening skills, patience, respect, and empathy for another's position.
Coping / Flexibility
Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.
Computer Literacy
Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Communication / People Skills
Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.
Commitment to Task
Ability to conform to established policies and procedures; exhibit high motivation.
BENEFITS
- Life Insurance
- Long-Term and Short-Term Disability
- Health Insurance
- Dental Insurance
- Vision Insurance
- 401(k) with up to 4% match
WORKING CONDITIONS
- Ability to work 12:30-21:00 Monday-Friday
- Ability to work overtime, if needed
- Works remotely (from home) in a quiet distraction-free space
- Extensive computers work with prolonged sitting and wearing of headset
