Bilingual Medicare Call Center Rep - Work From Home

Puerto Rico

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Not SpecifiedCompensation

Junior (1 to 2 years)Experience Level

Full TimeJob Type

UnknownVisa

Health Insurance, HealthcareIndustries

Requirements

Candidates must currently reside in Puerto Rico and be fully bilingual in English and Spanish, with the ability to speak, read, and write in both languages without limitations. A minimum of 1 year of customer service experience is required, along with demonstrated experience in providing strong customer service, attention to detail, and active listening. Prior experience managing multiple or competing priorities and proficiency with Microsoft Office applications, particularly Outlook and Teams, are also necessary. The role requires the ability to maintain a professional demeanor, practice strict confidentiality, and possess strong initiative.

Responsibilities

The Medicare Call Center Representative will represent the company by addressing incoming telephone, digital, or written inquiries from Medicare members, performing varied and moderately complex administrative and operational tasks. Responsibilities include handling inbound calls, making outbound calls to physicians and vendors to assist members, recording details of inquiries and taking appropriate action, and escalating unresolved customer grievances. The role involves interpreting policies, identifying work expectations, and ensuring quality standards while working with minimal direction and having some latitude over prioritization and timing.

Skills

Medicare

Call Center

Customer Service

Communication

Problem Solving

Data Entry

Bilingual

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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