Bilingual Healthcare Customer Service Representative - Remote Florida

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary As a Bilingual Healthcare Customer Service Representative - Remote Florida at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

• Answers telephones and responds to basic customer questions and/or forwards to appropriate personnel and provides consultancy utilizing knowledge and expertise on insurance and healthcare.
• Develops and implements general insurance and health care policies in accordance with state and federal laws and provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions.
• Responds to provider appeals and meets with providers to resolve problems/issues. Advises provider review councils, state officials and works with organized healthcare groups and associations on various medical issues related to insurance and healthcare programs.
• Processes calls in a manner that ensures service level agreements (SLAs) are met or exceeded. Records calls, processes requests and updates account history with results of inquiry to include proper documentation.
• Interfaces with team members, management, and customers in reference to customer service issues. Review and recommends modification to procedures and workflow as necessary to ensure efficient and effective processing of transactions.

What We’re Looking For

• Bilingual proficiency in English and Spanish is required
• 2 or more years of customer service experience in any industry
• Knowledge of basic help desk software, computer software and Microsoft Office applications
• Strong problem-solving skills to bring inquiries to effective resolution
• Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally
• Ability to understand your role on a team and identify the correct stakeholders to consult to resolve client inquiries

What You Should Expect In This Role

• Call Center Hours of Operation: 7:00 AM – 6:00 PM candidate must be able to work any assigned 8 hour shift between these hours.
• This is a remote position for candidates living in the state of Florida
• Video cameras must be used during all interviews, as well as during the initial week of orientation.
• Full-time (40 hours a week)
• Most benefits start on first day of employment
• Remote (work from home)
• In order to effectively work as a teleworker with Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.
• To Test your internet download and upload speed:
• Go to Google
• Search for Internet Speed Test or click here.

“This posting is intended for pipelining. We will accept applications on an ongoing basis.” The pay range for this position is $37,440 - $41,600 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for al…