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  • San Juan, PR

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Inbound Contacts Representative 2 - San Juan

Humana • San Juan, PR

Posted 1 month ago

Job Snapshot

Healthcare - Health Services, Insurance
Health Care, Insurance, Customer Service

Job Description

The Inbound Contacts Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries. The Inbound Contacts Representative 2 performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.

Job Requirements

As an Inbound Call Representative, you will perform as a Universal Agent, trained to assist our CarePlus members through a one-call resolution approach. You will provide guidance, education, and resolve any issue(s) for our members, which may include medical claims, benefits,  enrollment, pharmaceutical, transportation and grievances. 

Job Responsibilities

  • Address and document customer inquiries by  following department processes and CMS (Centers for Medicare/Medicaid) regulatory guidelines while working in an inbound contact center.
  • Actively seeks information to understand customer’s circumstances, problems, expectations and needs for resolving customer inquiries/issues.
  • Serve as an advocate and educator for CarePlus members in accessing and utilizing their Medicare Advantage plan benefits.  
  • Support health and create a sense of value for Careplus members.
  • Maintain familiarity with policies and procedures to comply with all HIPAA and  Centers for Medicare and Medicaid regulation.

We care about the health and wellness of you and your family. We offer a comprehensive benefits package that makes it easier to manage your health and provide financial security for you and your family. 

  • Benefit package that starts your 1st day of employment
  • 18 vacation days and 15 days sick leave
  • Associate engagement and appreciation activities
  • Earn cash/gifts/discounts through our associate wellness and rewards program
  • Quarterly Pay Incentives based on associate's  performance
  • Opportunity to learn the industry and build professional career

Job Requirements

  • High school diploma or equivalent required.
  • Bilingual in English and Spanish. Must be able to speak, read and write without limitations or assistance (language test required as condition of employment).
  • Three (3) plus years of experience in customer service required
  • Excellent oral and written communications skills required, as well as a high level of patience, understanding, and tact, often under difficult circumstances.
  • Must have a service oriented mentality and positive image when interacting with customers.
  • Must be able to work a minimum of an 8 hour shift Monday-Sunday, with overtime when there are business needs that can be projected and for non-projected events. 
  • Ability to work in a regulated environment.

Scheduled Weekly Hours


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