Customer Service Representative

Bilingual Customer Service Representative (Insurance)

We are seeking a customer-focused and detail-oriented Bilingual Customer Service Representative to support policyholders and providers within the insurance industry. This role is responsible for handling inquiries related to coverage, claims, and policy details while delivering a high-quality customer experience.

Key Responsibilities

• Handle a high volume of inbound and/or outbound customer service calls in a professional and efficient manner
• Assist customers with questions related to insurance policies, coverage, billing, and claims
• Explain policy details, benefits, and claim outcomes clearly and accurately
• Process customer requests including account updates, payments, and documentation
• Strive for first-call resolution while maintaining a positive and empathetic customer experience
• Accurately document all interactions and maintain up-to-date customer records
• Research and resolve discrepancies or issues in customer accounts
• Escalate complex or unresolved issues to the appropriate department
• Collaborate with internal teams to support efficient service operations
• Maintain knowledge of insurance products, policies, and regulatory requirements

Qualifications

• 3+ years of customer service experience (call center experience preferred)
• Bilingual proficiency in English and Spanish required
• Strong communication skills with the ability to explain complex information clearly
• Experience in a high-volume, fast-paced environment
• Strong attention to detail and problem-solving skills
• Ability to manage multiple tasks and prioritize effectively
• Proficiency with customer service systems, databases, and Microsoft Office

Preferred Qualifications

• Experience in insurance, healthcare, or claims processing
• Familiarity with Medicare, CMS guidelines, or insurance policies and procedures
• Prior experience in a call center or inbound support environment
• Knowledge of claims adjudication or billing processes

Skills & Competencies

• Customer service excellence and professionalism
• Empathy and patience when assisting customers
• Strong verbal and written communication
• Time management and multitasking
• Adaptability and ability to navigate changing processes

Work Environment / Additional Details

• Direct Hire
• Onsite
• Competitive compensation based on experience