QUALIFICATIONS/REQUIREMENTS:

• High School Diploma or three or more years of experience in insurance and/or customer service.
• Excellent customer service skills.
• Bilingual - English and Spanish required. French is an asset.
• Ability to interact with customers, clients, and medical providers in English and Spanish/French verbally and in writing.
• Proficient in computer systems and applications, including MS Office.
• Accurate data entry skills including reasonable typing speed.
• Flexible to work rotating shifts, including evenings, weekends and holidays (night shifts, based on business requirements)

The essential functions include, but are not limited to the following:

• Coordinate international and local medical assistance over the phone or email following set guidelines, in a timely and professional manner.
• Coordinate with Medical Providers for direct billing when possible and send the corresponding documentation.
• Read and interpret insurance policy documents and apply relevant information to specific situations.
• Answer provider calls requesting policy coverage information.
• Open cases and claims in our CRM system following set guidelines, methodology and processes.
• Collaborate with other members of the team to ensure quick resolution of cases/situations.
• Follow up on cases and communicate with insured/ corporate client and Medical Providers when necessary.
• Create a good rapport with providers in the network and outside the network.
• Work closely with Case Management and Claims to ensure client/insured receives proper care/follow up.
• Maintain professional and technical knowledge.
• Other duties as assigned.