Job ID: 1790310
Reference Code: KD-Healthcare-Customer Service Rep
Job Summary
We are seeking a Representante de Atención al Cliente for a contract/temporary opportunity in the healthcare services industry in San Juan, PR. This call center role is ideal for a customer-focused professional with 1-2 years of experience who enjoys helping members resolve issues, understand benefits, and navigate healthcare-related processes with care and accuracy.
In this role, you will support members through inbound and outbound calls, provide clear orientation, document interactions, and help resolve concerns in accordance with established procedures and regulatory guidelines. This opportunity offers a structured, team-oriented environment where strong communication, empathy, accuracy, and productivity are valued. Candidates who enjoy problem-solving, building positive member relationships, and working in a mission-driven healthcare support setting are encouraged to apply.
Key Responsibilities
- Conduct inbound and outbound calls to provide orientation, answer questions, and identify and resolve member concerns.
- Follow up with members regarding case status, service issues, enrollment matters, cancellations, disenrollments, missing ID cards, benefits, claims, and related topics.
- Document calls, member engagement activities, forms, logs, and case details accurately in the appropriate systems.
- Resolve member issues promptly or route inquiries to the correct department for additional handling.
- Identify grievances and appeals and support resolution in accordance with CMS regulations, policies, and procedures.
- Conduct quality surveys, manage objections, and provide product or process orientation to support member satisfaction and retention.
Compensation and Benefits
- Pay rate: $13.00 per hour.
- Job type: Contract/Temporary.
- Location: San Juan, PR.
Equal Opportunity Employer / Disabled / Protected Veterans
The Know Your Rights poster is available here:
https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf
The pay transparency policy is available here:
https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf
For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.
We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.
AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.
https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf
We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.
Required Qualifications and Skills
- Conduct inbound and outbound customer service calls in a healthcare call center environment.
- Provide member orientation related to enrollment, disenrollment, benefits, claims, coverage changes, and service issues.
- Document member interactions, call outcomes, forms, and case details accurately.
- Support productivity, quality, monitoring, and compliance expectations.
- 1-2 years of customer service, call center, or related client care experience.
- Strong verbal communication skills with the ability to explain healthcare-related information clearly and professionally.
- Ability to provide empathetic, patient, and solution-focused service to members.
- Strong attention to detail for reviewing applications, completing forms, and documenting information accurately.
- Ability to follow scripts when required while adapting conversations to address member needs effectively.
- Comfortable working with productivity metrics, monitoring standards, and quality expectations.
- Ability to identify and escalate issues to the appropriate department when needed.
- Knowledge of healthcare member services, benefits, claims, or CMS-related processes is helpful.
Preferred Qualifications
- Previous experience in a healthcare services call center.
- Experience handling member grievances, appeals, enrollment, disenrollment, benefits orientation, or claims-related inquiries.
- Bilingual communication skills may be helpful for supporting a diverse member population in San Juan, PR.