Bilingual Customer Service Representative in Austin, TX at Beacon Health Options

Job Description

ABOUT THE POSITION

We are currently seeking a dynamic Bilingual Customer Service Representative (CSR) to join our team at our office in Austin, Texas.  Under the direction of the Customer Service Management Team, the Customer Service Representative (CSR) is responsible for answering and responding to a high volume of telephone inquiries from members and providers. The incumbent’s responsibilities include providing accurate and thorough interpretation of benefits, eligibility, provider participation, claims payment and interpretation inquiries, resolving customer inquiries, facilitating problem resolution, and acting as a member/provider advocate by meeting or exceeding customers’ expectations.  The CSR is expected to take complete responsibility for every interaction with a customer by providing outstanding service as a means to build customer loyalty, improve customer retention and satisfy corporate customer service goals and objectives. 

Position Responsibilities:

• Provide timely, accurate, and courteous responses to a high volume of telephone inquiries from both members and providers.
• Achieve and maintain productivity and quality performance expectations.
• Interpret and effectively communicate benefits and eligibility and claims payment information to our customers.
• Facilitate resolution of complex claim issues
• Document all critical information related to contacts responded to in the appropriate FlexCare or CONNECTS screen/system.
• Manage pending inventory in a timely and accurate manner in order to meet or exceed quality and productivity standards.
• Provide timely follow-up with other internal departments to expedite resolution of difficult/aging inquiries, and when necessary escalate those issues to management for further handling.
• Keep abreast of all system, contractual, compliance standard changes and policy updates, and attend additional training sessions as necessary.
• Complete daily assigned tasks by management such as website inquiries, performance guarantee reports, negative coordination of benefit updates, authorization for disclosure forms, authorization updates, and correspondence.
• Perform additional duties and/or work additional hours as needed.  Mandatory overtime and working holidays may apply based on business needs.
• Comply with all the HIPAA Compliance regulations.

Position Requirements:

Education : High school diploma or equivalent.  An Associate’s Degree or equivalent related experience is preferred.

Relevant Work Experience :   One year experience in Customer Service, Health Care or Health Insurance is required.  Previous experience in an ACD call center environment is preferred.

Fluency in English and Spanish required. 

TO APPLY

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Beacon Health Options is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled
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