Bilingual Call Center Representative

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Humana

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1961

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

Humana is a healthcare company dedicated to making a positive impact on the health of individuals, communities, and the healthcare system as a whole. With a focus on putting health first, Humana serves a diverse range of populations, including seniors and the military, providing Medicare Advantage HMO, PPO, and PFFS plans. Humana is committed to fostering a culture of belonging and mutual respect, offering competitive and flexible benefits to ensure the financial security of its employees and their families. The company prides itself on creating an inclusive workplace where everyone has the opportunity to succeed.

📋 Description

• Represent CarePlus by addressing incoming telephone, digital, and written inquiries from Medicare members • Provide members with a resolution or pathway to resolution on each call • Address complex benefits questions, resolve issues, and educate members • Handle 20 to 35 inbound Medicare member calls daily in a high-volume call-center setting • Place outbound calls to physicians, DME vendors, pharmacies, and other entities for 60% to 70% of inbound calls • Accurately record inquiries, comments, complaints, transactions, and interactions • Take appropriate action based on recorded member interactions • Escalate unresolved and pending customer grievances • Interpret department policies and methods to complete assignments • Identify work expectations and quality standards with minimal direction • Proactively provide solutions while ensuring members’ health and safety

🎯 Requirements

• Currently live in the Commonwealth of Puerto Rico • Fully bilingual in English and Spanish, with ability to speak, read, and write both languages without limitations or assistance • Must pass an English/Spanish Language Proficiency Assessment using the Interagency Language Rating (ILR) test • 1+ years of customer service experience • Demonstrated strong customer service, effective communication, attention to detail, and active listening • Experience managing multiple or competing priorities • Experience using multiple computer applications/systems simultaneously • Proficiency with Microsoft Office applications, particularly Outlook and Teams • Ability to maintain a professional demeanor and strict confidentiality for sensitive information • Strong initiative, adaptability to change, and empathy • Must be willing to remain in the position for 12 months before applying to other Humana opportunities • Must work any assigned shift during 8:00 AM–8:00 PM Eastern Time / 9:00 AM–9:00 PM AST during Daylight Saving Time, Monday through Friday • Flexibility to work weekends, holidays, and mandatory overtime based on business needs • Hard-wired internet connection required; wireless, satellite, cellular, and microwave connections are not permitted • Minimum home internet speed of 25 Mbps download and 10 Mbps upload • Dedicated workspace without ongoing interruptions for member PHI/HIPAA protection • Resume must be attached in English in PDF or Word format

🏖️ Benefits

• Medical, dental and vision benefits • 401(k) retirement savings plan • Paid time off • Company holidays • Personal holidays • Paid parental leave • Paid caregiver leave • Short-term disability • Long-term disability • Life insurance • Work-from-home arrangement until further notice • Occasional travel to Humana offices for training or meetings may be required • Dedicated workspace requirement to protect member PHI / HIPAA information • Virtual training for the first 7 weeks