Bilingual (English/Spanish) Consumer Service Operations Representative III at Humana

Miami, Florida, United States

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

HealthcareIndustries

Requirements

Must be able/willing to travel between 3 different locations in Miami, Miami Beach, and Hollywood (zip codes 33155, 33141, 33024) daily on rotation
Bilingual English/Spanish: ability to read, write, speak fluently without limitations or assistance
Minimum of 1 year of customer service experience in a healthcare setting
Proficient in Microsoft Office, Outlook, Word, and Excel
Excellent verbal, listening, and written communication skills
Aptitude for quickly learning and navigating new technology, systems, and applications, as well as working knowledge of computers

Responsibilities

Perform daily activities across multiple service functions areas
Perform advanced administrative/operational/customer support duties requiring independent initiative and judgment
May apply intermediate mathematical skills
Perform installation, implementation, client support, client services, client administration, customer service, enrollment and eligibility, claims processing, and call center operations
Investigate and settle claims and customer service issues
Exercise discretion and judgment in prioritizing requests and interpreting/adapting procedures, processes, and techniques
Work under limited guidance due to previous experience and knowledge of administrative processes and organizational knowledge

Skills

Key technologies and capabilities for this role

Bilingual English/SpanishCustomer ServiceMicrosoft OfficeOutlookWordExcelClaims ProcessingEnrollmentEligibilityCall Center Operations

Questions & Answers

Common questions about this position

Is this position remote or onsite?

This is not a remote role and is located in the Miami, Florida area, requiring daily travel to different clinics in Miami, Miami Beach, and Hollywood.

What are the required qualifications for this role?

Required qualifications include willingness to travel between three locations in Miami, Miami Beach, and Hollywood daily, bilingual fluency in English/Spanish, at least 1 year of customer service experience in a healthcare setting, proficiency in Microsoft Office (Outlook, Word, Excel), and excellent communication skills.

What is the salary or compensation for this position?

This information is not specified in the job description.

What travel is required for this job?

You must be willing and able to travel daily between three different clinic locations in Miami, Miami Beach, and Hollywood (zip codes 33155, 33141, 33024).

What makes a strong candidate for this role?

Strong candidates will have the required bilingual fluency, healthcare customer service experience, and tech proficiency, plus preferred qualifications like an undergraduate degree, Medicare experience, medical terminology knowledge, or CNA/Medical Assistant background.

Humana

Health insurance provider for seniors and military

About Humana

Humana provides health and well-being services, focusing on Medicare Advantage plans for seniors, military personnel, and communities. Their plans include HMO, PPO, and PFFS options, designed to improve health outcomes through comprehensive and flexible coverage. Humana's revenue comes from government contracts and member premiums, and they aim to maintain high renewal rates by offering quality service and competitive benefits. The company stands out by fostering a culture of inclusivity and belonging among its employees, while also ensuring accessibility for all members, including offering free language interpreter services. Humana's goal is to deliver value to its members through an extensive provider network and innovative health solutions.

Louisville, KentuckyHeadquarters

1961Year Founded

IPOCompany Stage

Social Impact, HealthcareIndustries

10,001+Employees

Risks

Potential over-reliance on AI could disrupt operations if systems fail or are compromised.

Rising medical costs and tightening Medicare reimbursements may strain financial performance.

Leadership change with new CEO Jim Rechtin could lead to strategic disruptions.

Differentiation

Humana is a leader in Medicare Advantage plans, focusing on seniors and military personnel.

The company emphasizes inclusivity, offering free language interpreter services for accessibility.

Humana leverages AI and cloud technologies through a partnership with Google Cloud.

Upsides

Humana's investment in Healthpilot enhances digital enrollment for Medicare options.

The company is the first insurer to cover TMS therapy for adolescent depression.

Humana's focus on value-based care aims to improve outcomes for kidney disease patients.

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