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Customer Service Representative (Spanish Must)

CHICAGO-60608, IL, US
06/21/2021

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Required Skills

interpersonal skills

Company

Cloudious

Experience

Job Description

Responsible for inbound phone inquiries primarily dealing with either:
Member benefits and eligibility related to the Medicaid, CHP and FHP product lines or Provider benefits, eligibility, PEP and claim status, member pharmacy calls, utilizing prior approval skills (ACP/DME and CCD) and placing outbound calls on a routine basis.
Resolve issues with respect to benefits and eligibility by researching documentation, system information or gaining knowledge from other employees, management or departments.
Interact with customers, document call specifics and demonstrate quality program behaviors to create an outstanding relationship with each caller.
Work with outside vendors as needed to answer questions or resolve issues.
Respond to member correspondence/email in writing utilizing an existing Customer Service system letter to respond effectively to members.
Conduct orientation to new members by providing an overview of the member’s plan and pertaining administrative policy.
Education and Experience

High School Diploma, GED, or Equivalent work experience
Must be computer literate and able to multi-task – i.e. document call experience while using the Quality Program.
Excellent communication and interpersonal skills.
Bilingual fluency in English and Spanish
Preferred Qualifications

Healthcare/Insurance environment (familiarity with medical terminology, health plan documents, or benefit plan design)
Social work, behavioral health, disease prevention, health promotion and behavior change (working with vulnerable populations)
Sales or account management experience
Customer Service Experience