Call Center Agent II (Mexico)

Overview

HealthEdge® offers AI-powered operational infrastructure for health insurance companies, guaranteeing an enduring financial edge in an increasingly competitive market. We're experiencing strong market momentum, with a growing number of health plans choosing HealthEdge to modernize their operations and compete more effectively. As we expand, we're investing in the people who power that growth, making this a pivotal moment to join us and shape the future of healthcare technology. Learn more at HealthEdge.com.

Reporting to the Customer Service Manager, the Customer Service Associate will provide exceptional customer service to the UST customers via inbound Call Center Operations. The service center will be open from 8am-6pm CST USA and will occur related schedules.  

Duties/Responsibilities:

• Receive and respond to inbound phone calls for customer assistance
• Respond to outbound phone call requests
• Document all calls in ticketing and tracking systems
• Respond to customer inquiries and provide data to customers within a required time frame
• Act as liaison between claims department and providers
• Research customer claims in the primary payor systems
• Ensure highest level of customer service on every call
• Perform other duties as assigned or necessary

Required Skills/Abilities

• High school degree required; Bachelor’s degree preferred
• 2-3+ years of relevant professional experience in Healthcare claims operations or 2-3+ years of relevant experience in a Call Center environment
• Previous Health Care Call Center/Customer Service Experience.
• Must be able to work with minimal supervision.
• Maintain a full comprehensive understanding of the covered benefits, coding and reimbursement policies and contracts.
• Excellent verbal and written communication skills.
• Attention to detail and problem-solving skills
• Proficiency with MS Office applications, especially Word and Excel.

Overall Experience level:

• Some experience in customer service setting preferred
• Spanish speaking and written language proficiency preferred

Geographic Responsibility:  Remote, Mexico

Type of Employment: Full-time, permanent 

Work Environment: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job:  

• The employee is occasionally required to move around the office. Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception, and ability to adjust focus.  

• Work across multiple time zones in a hybrid or remote work environment. 

• Long periods of time sitting and/or standing in front of a computer using video technology. 

• May require travel dependent on company needs. 

The above statements are intended to describe the general nature and level of the job being performed by the individual(s) assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities, and skills required. HealthEdge reserves the right to modify, add, or remove duties and to assign other duties as necessary. In addition, reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position in compliance with the Americans with Disabilities Act of 1990.  Candidates may be required to go through a pre-employment criminal background check. 

HealthEdge is an equal opportunity employer. We are committed to workforce diversity and actively encourage all qualified persons to seek employment with us, including, but not limited to, racial and ethnic minorities, women, veterans and persons with disabilities. 

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