Call Center Rep - Bilingual

Job Description

Job Description

Call Center Representative - Bilingual

Location: Bellaire, TX

Pay Rate: Starting at $20.00/hour

Schedule: Monday-Friday | 7:00 AM-6:00 PM

Dean's Professional Services is seeking an experienced Bilingual Call Center Representative to support a leading healthcare organization in Bellaire, TX . This is an excellent opportunity for a customer-focused professional with healthcare insurance, Medicaid, and call center experience who enjoys helping members and providers navigate questions and resolve concerns.

Responsibilities

• Serve as a Member and Provider Advocate , providing knowledgeable and compassionate assistance with healthcare-related questions and concerns.

   

• Handle inbound calls from members, providers, prospective members, and other healthcare partners.

   

• Assist with questions regarding eligibility, benefits, authorizations, claims, referrals, appointments, and other healthcare services .

   

• Research member and provider issues, collaborate with internal departments, and facilitate appropriate resolutions.

   

• Act as a liaison between members/providers and internal departments to ensure concerns are addressed promptly.

   

• Gather relevant information and provide accurate responses or recommendations.

   

• Assist members with timely appointment scheduling when needed.

   

• Support members and providers throughout the complaint and appeal process .

   

• Interact with callers in a professional, tactful, and empathetic manner, including individuals who may be upset or frustrated.

   

• Verify caller identity and follow HIPAA requirements before disclosing protected health information (PHI).

   

• Accurately document calls, interactions, and resolutions in applicable systems, including Epic and other healthcare platforms.

   

• Complete assigned work queues and after-hours call center notifications as required.

   

• Escalate complex issues, recurring concerns, or potential systemic problems to leadership.

   

• Support day-to-day call center operations and maintain established performance and quality standards.

   

Qualifications

• High school diploma or GED required.

   

• At least 1 year of customer service experience within managed care or the insurance industry , or call center experience in any industry.

   

• Bilingual English/Spanish required.

   

• Medicaid experience required.

   

• Call center experience required.

   

• Must be able to identify and discuss common call center metrics/KPIs .

   

• Knowledge of managed care, health insurance, and healthcare terminology preferred.

   

• Strong verbal and written communication skills.

   

• Excellent listening, interpersonal, and problem-solving skills.

   

• Ability to remain calm, professional, and empathetic when handling upset or difficult customers .

   

• Strong multitasking and organizational skills.

   

• General computer literacy and experience with call center applications.

   

• Typing speed of 35 WPM required.

   

• Epic EMR experience is a plus.

   

• Ability to work independently while also contributing effectively to a team environment.

   

Why Join Dean's Professional Services?

• Competitive pay starting at $20.00/hour .

   

• Comprehensive benefits package, including medical, dental, vision, and 401(k) .

   

• Opportunity to expand your experience in healthcare, managed care, and h