Bilingual Claims Customer Service Representative POST NUMBER: 465371

Vaco has partnered with a well-established insurance organization to fill a Bilingual (Spanish) Customer Service Representative role supporting policyholders and providers. This position serves as a primary point of contact for high-volume inbound inquiries, delivering accurate information, resolving issues efficiently, and ensuring an exceptional customer experience. The ideal candidate will have strong knowledge of Medicare Supplement insurance and claims adjudication processes, with a focus on achieving one-call resolution. Fluency in both English and Spanish is required. If you are a detail-oriented, empathetic professional with insurance industry experience—apply today.
Responsibilities

• Handle high-volume inbound calls from policyholders and providers in both English and Spanish, delivering prompt and professional service
• Provide accurate and detailed information regarding insurance policies, benefits, coverage, and claims
• Resolve customer concerns efficiently, striving for one-call resolution whenever possible
• Assist providers with claim processing, including claim submission guidance and clarification of reimbursement procedures
• Demonstrate knowledge of Medicare Supplement insurance and healthcare claim adjudication processes
• Educate customers on claim determinations, policy provisions, and CMS-related guidelines
• Maintain accurate documentation of all customer interactions within customer service systems
• Collaborate with Claims Examiners and other internal departments to ensure timely and seamless issue resolution
• Identify and escalate complex inquiries appropriately
• Uphold company standards of accuracy, integrity, empathy, and professionalism in every interaction
• Stay current on CMS guidelines, Medicare Supplement updates, and internal policy changes

• High school diploma or equivalent required
• Minimum 3 years of customer service experience, preferably in the insurance or healthcare industry
• Fluency in English and Spanish (spoken and written) required
• Strong knowledge of Medicare Supplement insurance and healthcare claim adjudication processes preferred
• Experience handling high-volume inbound calls with a focus on first-call resolution
• Excellent verbal and written communication skills

Determining compensation for this role (and others) at Vaco/Highspring depends upon a wide array of factors including but not limited to the individual’s skill sets, experience and training, licensure and certifications, office location and other geographic considerations, as well as other business and organizational needs. With that said, as required by local law in geographies that require salary range disclosure, Vaco/Highspring notes the salary range for the role is noted in this job posting. The individual may also be eligible for discretionary bonuses, and can participate in medical, dental, and vision benefits as well as the company’s 401(k) retirement plan.