Bilingual Customer Service – Remote Jobs

Job Type: Bilingual Customer Service from home
Location: Georgia work from home
Company: SKYGEN

Position Description:

Our customer service representatives need to be adept at solving problems and have a strong sense of empathy for their clients. They must constantly take the time to carefully listen to and comprehend their inquiries in order to find a workable solution and create a positive customer experience.

What will YOU spend each day working on?

• Helping callers seeking dental, medical, or vision services find a local provider by providing information on their eligibility, benefit coverage, authorizations, and claims;
• Use your understanding of the claim modification and resubmission procedures to choose the best response to provider requests.
• In order to guarantee that providers obtain a timely resolution, submit input to the Provider Relations team on high-level claim issues, such as but not limited to problems with reimbursement schedules or inconsistent information.
• Assist with enrollment procedures, such as selecting primary care physicians and updating data on third-party insurance.
• Serve as a point of contact between our company and the client’s member services team to address matters like eligibility and the submission of appeals and grievances.
• Update providers who inquire about the progress of their application for certification.
• Identify provider-related inquiries that could be resolved by using the provider web portal, and inform these callers of the advantages of making use of the available technology.
• Ensure that all calls are answered in accordance with customer and business policies.
• Ensure that call information and resolution are accurately recorded in our internal systems.
• Use efficient dispersion strategies where required to make sure that our clients feel heard, appreciated, and supported.
• Accurately determine which issues need to be escalated to the leadership team.
• Provide management with recommendations on process and system improvements as additional responsibilities.
• Keep our Provider Relations team informed of any discrepancies in the provider handbook, changes in locations, or other provider-related issues.
• When appropriate, take part in departmental projects.

What requirements must YOU meet in order to be a good candidate?

• High school diploma or the equivalent is the minimum level of education, licenses, and/or certificates required.

Required Experience Level

• 1–3 years of customer service experience relevant to your career (reception, call center, banking, retail)
• Knowledge, Skills, and Abilities Necessary
• Basic familiarity with Microsoft Office suites, including Word, Excel, and Outlook.
• Being able to work an 8-hour shift from 6 am to 8 pm central time.
• The capacity to do occasionally required overtime.
• Excellent communication and listening abilities
• Superior customer service abilities, including the capacity to empathize naturally
• Strong typing and data input abilities Strong navigational skills and the capacity for multitasking
• Outstanding attention to detail Critical thinking abilities to swiftly assess and thoroughly comprehend a particular request or client need, and then to utilize knowledge and resources to give the required answers.