Note: The job is a remote job and is open to candidates in USA. The company is a leading provider of government-sponsored health and human services. It is seeking a Bilingual Senior Customer Service Representative to support a high-volume healthcare contact center by assisting customers with eligibility, enrollment, benefits, and available services, while resolving inquiries and documenting case activity accurately.
Responsibilities
- Handle inbound and outbound calls with customers, healthcare providers, and other program stakeholders
- Provide accurate and unbiased information regarding healthcare eligibility, enrollment, services, benefits, and program requirements
- Assist customers with understanding their healthcare program options and navigating enrollment-related questions
- Research customer and case histories across multiple systems to resolve questions and service issues
- Investigate and resolve complex or escalated inquiries while maintaining a high level of customer service
- Process enrollment, disenrollment, and other program-related transactions accurately and efficiently
- Review and interpret customer, beneficiary, provider, and system information to determine appropriate next steps
- Maintain current knowledge of program policies, procedures, and compliance requirements
- Coordinate with internal teams, healthcare plans, and other partners to resolve customer inquiries
- Document customer interactions and case activity accurately within required systems
- Identify recurring issues, trends, or process gaps and escalate concerns appropriately
- Meet established productivity, attendance, quality assurance, and performance expectations
- Maintain strict confidentiality and security of customer and healthcare-related information
- Participate in special projects, audits, training, or additional operational support as needed
Skills
- High school diploma or GED required
- Minimum of **1 year of relevant professional experience** in customer service, call center operations, healthcare support, benefits, insurance, enrollment, or a related environment
- **Fluent in both English and Spanish required.**
- Strong verbal and written communication skills
- Ability to communicate professionally with customers from diverse backgrounds
- Comfortable handling a high volume of inbound and outbound calls
- Strong research, problem-solving, and issue-resolution skills
- Ability to navigate multiple computer systems simultaneously
- Strong attention to detail and ability to accurately document customer interactions
- Must be able to work independently in a professional remote environment
- This position is fully remote and candidates may reside anywhere within the **contiguous United States**, provided they are able to work Eastern Time Zone hours
- Candidates must have a reliable, traditional wired home internet connection. Recommended minimum speeds are:
- * **50 Mbps download**
- * **20 Mbps upload**
- Cellular/mobile-based internet services are not permitted
- **Training:** Monday–Friday, **8:00 AM–4:30 PM ET**
- **Important:** 100% attendance is required throughout training and nesting. Candidates should not have any planned appointments or time off during this period. Employees will be expected to remain **on camera throughout training and nesting**
- The anticipated regular shift is approximately **10:30 AM–7:00 PM ET**, although schedules are subject to change based on business needs
- Previous healthcare, Medicaid, insurance, benefits, eligibility, or government program experience is a plus
Benefits
- Fully remote work arrangement within the contiguous United States
- Company equipment will be provided and shipped directly to the employee
Company Overview