Healthcare Customer Service Representative

Our client, a major PBM (Pharmacy Benefit Services) entity owned by 20 non‑profit health plans serving >33 million members and benefits manager of government programs including Medicare and Medicaid, seeks an accomplished Spanish Customer Service Representative
.

• Candidates must be flexible to work within a 24/7 call center environment, although there are only day and mid‑day shifts available (no graveyard / overnight shifts).
• Must have a hard‑wired internet connection, and a quiet workspace.
• Training is 2‑4 week (paid).

• The main function of a Healthcare Customer Service Representative is to interact with customers to provide information in response to inquiries about products and services and to handle and resolve complaints. A typical Customer Service Specialist is responsible for determining the client’s issue, offering possible solutions, or providing follow‑up as needed. Customer service agents may be inbound, outbound, or a combination of both.
• Resolve customers’ service or billing complaints by performing activities such as exchanging merchandise, refunding money, and adjusting bills.
• Contact customers to respond to inquiries or to notify them of claim investigation results and any planned adjustments.
• Refer unresolved customer grievances to designated departments for further investigation.
• Keep records of customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken

• Education:
  
  High school diploma or GED
• 0-2 years customer service‑related experience required.
• Candidates must have customer service experience, particularly in high call volume environments.
• Previous experience with computer applications, such as MS Outlook or data entry software.
• Ability to accurately document and record customer/client information.
• Proficiency in computer software navigation and dual screens is essential.
• The ability to handle complex calls, demonstrate critical thinking, and problem‑solving skills is crucial.
• Strong communication skills are a must.
• Preferred
  
  Skills:
  
  A pharmacy background is preferred but not mandatory