Remote Bilingual Customer Service Representative - TEKsystems

Description:

Convey a positive image of the company by promptly responding to customer phone inquiries and

determining the appropriate actions to resolve issues, gather and provide information, and offer

assistance.

▪ Deliver service that meets or exceeds department performance standards for Quality, Adherence, and

One-touch Resolution.

▪ Utilize multiple company applications to research and resolve complex issues relating to benefit

information, claims adjudication, eligibility verification, prior authorization, and other PBM processes.

Use established processes & tools as applicable to escalate issues, request follow up action, or obtain

assistance from other areas of the organization as necessary.

▪ Educate callers and provide information about override guidelines, benefit plan restrictions, prior

authorization requirements, grievance and appeal processes, and other PBM functions as specified by

health plan sponsors.

▪ Follow up with callers as appropriate to ensure customer satisfaction and timely response to requests.

Diffuse irate or emotionally upset customers by appropriately listening to issues, de-escalating g the

customer, and providing positive solutions to resolve concerns.

▪ Support the department strategy by delivering Customer Service Excellence through telephone

courtesy, prompt response to callers, anticipation of customer needs and concerns, solution-oriented

problem solving, and adherence to call center scripts, greetings, and call closing messages.

▪ Identify opportunities and make recommendations to department leadership for improvement of

workflow processes, operating systems, training programs, reference materials, and quality initiatives

that enhance the customer experience.

▪ Keep current on new plan information and instructions by attending and participating in staff meetings,

huddles, company-required training programs, and other activities that develop skills, build teamwork,

and provide updated information.

Skills:

Customer service, Customer support, Call center

Additional Skills & Qualifications:

call center

customer service

Bilingual Spanish

PBM

pharmacy

healthcare

Experience Level:

Entry Level

Benefits:

o  Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms.  If eligible, the benefits available for this temporary role may include the following: 

§  Medical, dental & vision 

§  Critical Illness, Accident, and Hospital 

§  401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available 

§  Life Insurance (Voluntary Life & AD&D for the employee and dependents) 

§  Short and long-term disability 

§  Health Spending Account (HSA) 

§  Transportation benefits 

§  Employee Assistance Program 

§  Time Off/Leave (PTO, Vacation or Sick Leave) 

About TEKsystems:

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.