Puerto Rico careers

Job Title: Bilingual Customer Service Representative
Job Category: Entry Level
Position Type: Full Time
Location: San Juan, PR

Job Description:

• Responsible for successfully completing the required basic training.
• Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues.
• Must pass the appropriate pre-employment test battery.
• Primary duties may include, but are not limited to:
• Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
• Analyzes problems and provides information/solutions.
• Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis.
  Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Researches and analyzes data to address operational challenges and customer service issues.
• Provides external and internal customers with requested information. Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
• Uses computerized systems for tracking, information gathering and troubleshooting. Seeks, understands and responds to the needs and expectations of internal and external customers.

Requirements:

• Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims.
• Requires a HS diploma or equivalent and previous experience in an automated customer service environment; or any combination of education and experience which would provide an equivalent background.
• Bilingual (Spanish) or multi-language skills required.
• Must be able to pass a validated language test/assessment.
• Strong communication skills (bi-lingual)
• Excellent computer skills (able to navigate in multiple applications); fast typing skills
• Good problem-solving skills – investigating issues and driving effective problem resolution
• Healthcare experience (preferred)

Use this link to submit your resume via email.

Job Title: Performance Quality Analyst I
Job Category: Mid-Level
Position Type: Full Time
Location: San Juan, PR

Job Description:

The Performance Quality Analyst I is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by organizations within the enterprise.  Included are processes related to customer service written and verbal inquiries.  Primary duties may include, but are not limited to:

• Assists higher level auditor/lead on field work as assigned, including performing special audits and targeted audits as requested by internal management.
• Participates in pre and post implementation audits of member inquiries and the corrective action plan process.
• Analyzes and interprets data and makes recommendations for change based on judgment and experience, applies audit policy, and assesses risks to minimize our exposure and mitigate those risks.
• Documents audit results, documents findings, and suggests appropriate remediation.
• Provides coaching and education to frontline staff on audited inquiries and identified opportunities for improvement.

Qualifications:

• Requires a BS/BA
• 2+ years related experience in an enrollment and billing, claims and/or customer contact automated environment (preferably in healthcare or insurance sector) or any combination of education and experience, which would provide an equivalent background.
• Analytical and problem-solving skills.
• Decision-making skills.
• Excellent verbal and written communication skills.
• Adaptability and flexibility.
• Collaborative and team oriented.
• Ability to provide effective coaching to others.
• GBD call center experience with Medicare products strongly preferred. 

Use this link to submit your resume via email.

Job Title: Call Center Supervisor
Job Category: Mid-Level
Position Type: Full Time
Location: San Juan, PR

Job Description:

Responsible for providing oversight to our Pharmacy Prior Authorization customer service staff. Responsible for establishing departmental policies and procedures. Primary duties may include, but are not limited to:

• Directs implementation and administration of pharmacy benefit programs. Prepares and communicates information to appropriate parties regarding pharmacy benefit programs, procedures, changes, and government mandated disclosures.
• Audits to monitor efficiency and compliance with policies; prepares specialized reports; may be assigned to special project work consistent with the role and dictated by the needs of the business.
• Hires, trains, coaches, counsels, and evaluates performance of direct reports.

Minimum Qualifications:

• Requires BA/BS degree and a minimum of 1 year of experience in a leadership role and a minimum of 5 years related customer service experience; or any combination of education and experience which would provide an equivalent background.
• For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

Preferred Qualifications:

• 1 to 3 years of previous contact center management experience, preferably PBM experience or previous experience working in healthcare and/or insurance industries, managing up to team size of 25 associates.
• Proven ability to translate business strategy into directions, plans and measurable objectives.
• Strong understanding of business data and analytics of Key Performance Indicators.
• Experience working in a highly regulated/compliance call center work environment- HIPAA, PHI, etc. Understanding of common contact center objectives, expectations, metrics.
• Results and Performance driven, will strive for success, both individual and department goals.
• Resolution-focused- A problem solver, takes accountability and initiative.
• Aptitude for remote work, to work independently, while being connected to a virtual team and in office team. Agility to be flexible with work schedule, including coverage for weekends and holidays as needed.
• Strong leadership skills and competencies. Solid communicator, both verbal and written.
• Oversee staffing needs including hiring decisions, staff development, performance appraisals, promotions and terminations.
• Passion to deliver excellent Customer Service.
• Compassionate, willingness to assist, a strong desire to coach and develop associates, high level of integrity.
• Experience with: PA HUB, MS Office, Verint, Genesys, WDE (Workspace Desktop Edition- Phone System) COS (Client Online Service), FACETS, Ability to troubleshoot general system problems to assist associates.

Use this link to submit your resume via email.

Job Title: HR Generalist
Job Category: Mid-Level
Position Type: Full Time
Location: San Juan, PR

Job Description:

The HR Generalist will be responsible for supporting the day-to-day HR operations of the healthcare call center company. This includes but is not limited to recruiting, employee relations, performance management, compensation and benefits administration, and compliance with applicable laws and regulations.

Key Responsibilities:

• Recruitment: Collaborate with hiring managers to create job descriptions, post job openings, and source candidates through various channels. Conduct phone and in-person interviews, perform reference checks, and make job offers to successful candidates.
• Employee Relations: Provide guidance and support to employees on HR-related matters such as conflict resolution, employee grievances, and disciplinary actions. Maintain employee records and ensure compliance with company policies and procedures.
• Performance Management: Work with managers to develop performance improvement plans and conduct performance reviews. Develop and implement employee training programs to enhance skills and improve performance.
• Compensation and Benefits: Administer employee compensation and benefits programs, including health insurance, retirement plans, and leave policies. Ensure compliance with applicable laws and regulations.
• Compliance: Ensure compliance with federal and state employment laws and regulations, including EEO, FMLA, and ADA. Maintain up-to-date knowledge of relevant laws and regulations and implement policies and procedures to ensure compliance.
• HR Reporting: Compile and analyze HR data to generate reports and identify trends. Use data to develop strategies to improve HR processes and practices.

Qualifications:

• Bachelor's degree in Human Resources or related field 2-3 years of experience in HR, preferably in a healthcare or call center environment
• Knowledge of federal and state employment laws and regulations
• Strong communication and interpersonal skills
• Ability to work independently and manage multiple priorities.
• The HR Generalist will report to the HR Manager and work closely with other members of the HR team. They will also collaborate with managers and employees across the organization to ensure a positive work environment and support the achievement of business objectives.

Use this link to submit your resume via email.

Job Title: Trainer
Job Category:
Position Type: Full Time
Location: San Juan, PR

Job Description:

Responsible for facilitating a variety of performance-based learning events.  Training is typically focused primarily on concrete skills related to training on processes and procedures but may include soft skills content.

Primary duties may include, but are not limited to:

• Facilitates learning events that are performance-based in nature and across multiple platforms.
• Delivers synchronous and asynchronous learning events using varied media in virtual and global environments.
• Employs rapid course development methodologies to quickly meet client needs.
• Exercises classroom management, including learner performance and escalates issues to Learning & Development and client leadership when necessary.
• Consults and solves learning solutions including: identifies client training needs, successfully uses performance consulting to analyze data and identify root cause to determine appropriate learning solutions, develops service level agreements and meets with clients to obtain approval.
• Measures tracks and evaluates learner and client satisfaction. Thinks and acts globally and is aware of learning and cultural differences both domestically and globally that drive learner effectiveness.
• Keeps technical skills updated.
• Requires BA/BS in related field and a minimum of 2 years of training experience; or any combination of education and experience, which would provide an equivalent background.

Use this link to submit your resume via email.