Bilingual Customer Service Representative

Job Description

Job Description

Job Overview : The role requires communication among medical providers, our client, and members. The customer service rep is to coordinate treatment and provide authorizations / issue GOPs for members in Latin America, Europe, etc. Respond to inquiries about authorizations and documentation requirements.

Responsibilities and Duties :

• Coordinate and determine approvals, eligibility, and inform the medical providers, as well as issue GOPs according to policy and client authorizations
• Tracking and follow-up of all cases, ensuring appropriate follow-up with the medical providers
• Provide guidance, support, and advice to international members seeking medical treatments or procedures
• Responds to routine phone inquiries and written correspondence related to authorizations and claims status
• Verify payments and / or denials, as well as treatment authorization status, and inform the proper party accordingly
• Able to be a part of an on-call / duties rotating schedule (after regular office hours and weekends)

Qualifications :