Call Center Specialist
Location
Florida
Posted
74 days ago
Salary
$53.7K - $72.6K / year
Seniority
Entry Level
Job Description
Call Center Specialist
Humana
Title: Call Center Specialist Location:Miami, Florida widget:Full time Category:Social Worker CarePlus Job ID:R-412427 Job Description: Become a part of our caring community The Telephonic Call Center Specialist / Care Coach 1 assesses and evaluates member's needs and requirements. We do this to achieve and maintain a wellness state. The specialist guides members/families toward resources and facilitates interaction with them. These resources are appropriate for the care and wellbeing of members. You will report to the Manager, Consumer Service Operations As the Telephonic Call Center Specialist / Care Coach you will - Inbound and Outbound calls from member, inquires or agents - The dialer will call the member and connect them to the associate automatically - Employ a variety of case management strategies, approaches and techniques to manage a member's case. - Identify through a screening process for potential eligibility for state and federal benefits. - Ensure member is progressing towards desired outcomes by continuously monitoring Member's case through use of assessment, data, and conversations with members, active planning and educating the member on potential resources. Use your skills to make an impact Required Qualifications - 1 or more years of Telephonic environment experience handling inbound and outbound calls - Live in the Miami, FL area - Microsoft Office Programs Word and Excel - Current valid Driver's license - Travel up to 25% or more at times to include home visits and events - Hybrid Home / Office- working 1 to 5 days a week in the Miami office, based on business needs - Monday-Friday 8:00 AM-5:00 p.m. EST, Overtime based on business needs and hours could include weekends/holidays. - During the Medicare Annual Election Period, September to December, must be able to work Monday through Friday between the hours of 8am-7pm EST but also subject to Overtime based on business needs and hours could include weekends/holidays. Preferred Qualifications - Associate Degree - Microsoft Office PowerPoint - Call center experience. - Healthcare knowledge or experience - Experience in member services and a call center environment specifically but not limited to Medicare & Medicaid recipients - Previous experience with electronic case note documentation and experienced with documenting in multiple computer applications/systems - Knowledge of community health and social service agencies and additional community resources reviews - Bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance. See Additional Information on testing Additional Information - This is a hybrid office position and going into the Miami, FL office - Monday-Friday 8:00 AM-5:00 p.m. EST, Overtime based on business needs and hours could include weekends/holidays. - During the Medicare Annual Election Period, September to December, must be able to work Monday through Friday between the hours of 8am-7pm EST but also subject to Overtime based on business needs and hours could include weekends/holidays. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested - Satellite, cellular and microwave connection can be used only if approved by leadership - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $53,700 - $72,600 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About Us About CarePlus Health Plans: CarePlus Health Plans is a recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years. CarePlus strives to help people with Medicare, or both Medicare and Medicaid, achieve their best possible health and wellness through plans with benefits and services they care about. As a wholly owned subsidiary of Humana, CarePlus currently serves Medicare beneficiaries throughout 21 Florida counties. About Humana: Humana Inc. (NYSE: HUM) is a leading U.S. healthcare company. Through our Humana insurance services and our CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health - delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare and Medicaid, families, individuals, military service personnel, and communities at large. Equal Opportunity Employer It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Related Guides
Related Categories
Related Job Pages
More Call Center Representative Jobs
Care Manager - Patient Call Center
IQVIAIQVIA is a publicly-traded healthcare intelligence company founded in 2016 upon the merger of two market leaders: Quintiles and IMS Health. With locations aroun
Title: Care Manager - Patient Call Center (Remote) Location: Flagstaff United States Job Description: Position Summary: Care Managers are responsible for contacting insurance companies to obtain correct eligibility information, perform benefit investigations, copay assistance and check prior authorization and/ or appeal status. The information contained herein is intended to be an accurate reflection of the duties and responsibilities of the individuals assigned to this position. They are not intended to be an exhaustive list of the skills and abilities required to do the job. IQVIA reserves the right to revise the job or to require that other or different tasks be performed as assigned. This role will be a contract role with IQVIA managed by an external agency, with the opportunity to be converted to an IQVIA full-time employee. Care Manager As the only global provider of commercial solutions, IQVIA understands what it takes to deliver nationally and internationally. Our teams help biopharma gettheir medicinestothe people who need them. We help customers gain insight and access to their markets andultimately demonstratetheirproduct'svalue to payers,physiciansand patients. A significant part of our business is acting as thebiopharma'ssales forcetophysicians or providing nurses to educate patients or prescribers. With the right experience, you can help deliver medical breakthroughs in the real world. Position Summary: Responsibilities will vary by program and its lifecycle. Care Manager's maybe responsible forcontacting insurance companies to obtain correct eligibility information, perform benefit investigations, copayassistanceand check prior authorization and/or appeal status. Care Managers may alsobe responsible fordirectly contacting patients and/or providers to evaluate eligibility forassistanceprograms and/or variedadherencesupport. This is aremoteposition. Job Responsibilities: - Perform outbound calls to obtainappropriate informationanddocumentaccurately. - Responsible for answering in-bound calls andassistingcustomers withpharmacy relatedservices. - Maintain strict professionalism in all communication methods while providing efficient, courteous, and friendly service. - Contact insurance companies for benefit investigation and coverage eligibility. - Provide prior authorizations and appeals support. - Assistpatients with the enrollment process for manufacturer and non-profitorganizationcopayassistanceprograms. - Update job knowledge byparticipatingin educational opportunities and training activities. Work efficiently both individually and within a team toaccomplishrequired tasks. - Maintain and improve quality results by adhering to standards and guidelines by meeting quality standards set forth by program KPI's. - Report ADE's according to program policy and guidelinesAdhereto all HIPAA guidelines Mayassistwith onboarding new employees. Schedule: - Must be available for an8 hourshift between 8am-8pm EST RequiredQualifications: - High School Diploma or equivalent - Minimum oneyearexperience in medical billing, reimbursement, insurance verification, or similar related medical office experience. - Previousdata entry experience (minimum three months) and ability to type 30wpm+. - Able todemonstratehigh attention to detail in work. - Mustbe computer savvy,to includenavigating multiple computer tabs,monitors,and applications. - Advanced ability/knowledge of all Microsoft Suite programs (Teams, Word, Excel, Outlook,etc.) and soft phone systems (WebEx, Mitel,Shoretel, etc.). - Exceptional communication skills, both written and verbal. - Able to work in a virtual team environment by being available and responsive during working hours. - Excellent follow through This is a remote position. - Employees must have a private workspace free of distraction to adhere to HIPAA compliance/guidelines. - Workspace must include internet plug-in accessibility. Wi-fi connectivity is notpermitted. - Mustresidein country wherethe jobis posted. Preferred Qualifications: - Some College. - Bilingual Spanish - English - Previousexperience in Patient Support Services (Hub). - PreviousCustomer Service experience in the healthcare field. IQVIA is a leading global provider of clinical research services, commercial insights and healthcare intelligence to the life sciences and healthcare industries. We create intelligent connections to accelerate the development and commercialization of innovative medical treatments to help improve patient outcomes and population health worldwide. IQVIA is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by applicable law. IQVIA is committed to integrity in our hiring process and maintains a zero tolerance policy for candidate fraud. All information and credentials submitted in your application must be truthful and complete. Any false statements, misrepresentations, or material omissions during the recruitment process will result in immediate disqualification of your application, or termination of employment if discovered later, in accordance with applicable law. We appreciate your honesty and professionalism. The potential base pay range for this role is $22.00 - $23.00 per hour. The actual base pay offered may vary based on a number of factors including job-related qualifications such as knowledge, skills, education, and experience; location; and/or schedule (full or part-time). Dependent on the position offered, incentive plans, bonuses, and/or other forms of compensation may be offered, in addition to a range of health and welfare and/or other benefits.
Registered Nurse - At Home Services Are you driven by the opportunity to make a real impact in the lives of older Australians? Do you find purpose in supporting people to live independently, safely, and confidently in their own homes? Are you looking to be part of a supportive, values‑led organisation where your work truly matters? Join us today! Key Features - A comprehensive range of Employee Benefits from health & wellness to professional development opportunities - Flexible Monday to Friday schedule with remote work supported - Supportive team culture where your contributions matter - Join an organisation that values clients and staff - Apply your care coordination and planning skills to support independent living at home About the role As a Registered Nurse supporting clients across Sydney’s Inner West, Eastern and South‑East suburbs, you will play a key role in delivering high‑quality clinical care that enables older Australians to continue living safely and independently in their own homes. You’ll build meaningful relationships with clients and their families, provide expert clinical guidance, and support each person to optimise their health, wellbeing, and independence. Your day may include: - Visiting clients at home for clinical assessments, nursing care, and ongoing monitoring - Developing, implementing, and reviewing individualised care plans - Building strong, supportive relationships with clients, families, and carers - Working with multidisciplinary teams, GPs, and allied health to ensure coordinated care - Actioning referrals and clinical recommendations promptly The role is offering an hourly rate ranging from $45.64 to $55.27 plus $0.99/km travel allowance* between clients plus super and access to salary packaging.*To help ease some of the pressure from rising fuel costs, employees who claim Vehicle/Travel (per km) reimbursement will receive a temporary increase of 5 cents per kilometre for all reimbursable journeys until May 2026, pending review. What do we need from you? - Registered Nursing qualifications with current AHPRA registration - Minimum 2 years clinical experience in community aged care - Current Australian driver’s licence - Excellent written and verbal communication and computer skills - Sound clinical decision making and problem-solving skills - Demonstrated ability to work independently and as part of a team - Demonstrate an understanding and appreciation of BaptistCare’s Christian identity and promote the organisation’s values through interactions at work About Us BaptistCare is a leading purpose-led care organisation, guided by our Christian identity and serving people and communities across Australia for more than 110 years. We support people to live better through aged care, home care, retirement living, community services, disability support and housing. We know that life’s challenges can make our world feel smaller. With the right people alongside us, it can feel more connected, supported and hopeful again. That’s what we work towards every day - enriching lives through communities of care. Today, more than 70,000 customers, 12,000 employees and close to 2,000 volunteers are part of our communities across Australia. BaptistCare – Inspired by Jesus to champion care for all The Employee Benefits are endless when you join BaptistCare! Enjoy access to salary packaging which may increase your take-home pay, novated leasing, rewards and recognition, programs to support your wellbeing, employee referral program and retail discounts to name a few. Applicants are encouraged to apply as soon as possible as applications may be reviewed prior to the closing date. Closing Date is subject to change without notice.
Si quieres ser parte de una de las compañías más innovadoras y quieres transformar positivamente la vida de las personas. ¡Esta oportunidad es para ti! Estamos en búsqueda de Asesor(a) Servicios Contact Center - Comercial ¿Qué harías? Contribuir en la calidad y oportunidad del servicio por medio de la gestión de llamada de entrada, salida y otros canales de atención; según el procedimiento definido y el tipo de servicio, línea o campaña, con el fin de asegurar las metas propuestas por los negocios en términos de resultados operativos, de calidad y comerciales, además de responder por la gestión comercial inbound y/o outbound para garantizar el cumplimiento de los objetivos comerciales y/o de presupuesto asignados por el negocio. Lo que buscamos de ti: Formación: Bachiller Experiencia: 6 meses de experiencia en atención, servicio al cliente y/o gestión comercial en Contact Center ¿Cuáles serían tus condiciones? Salario $1.786.000 con todas las prestaciones de ley Pago por cumplimiento de indicadores establecidos Contrato Fijo prorrogable. Modalidad : Teletrabajo Horario de 44 horas semanales. Turnos rotativos - Lunes a sábado, de 7:00 a.m. a 7:00 p.m. ¿Qué esperas para tomar este nuevo reto?, ¡juntos generáremos oportunidades para el cierre de brechas sociales!
Senior Patient Access Services Representative
NorthwellThe salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).
Job Description Performs a variety of registration, insurance verification, scheduling and billing duties in support of inpatient and outpatient access to medical services. Completes complex tasks. May aid or train other Representatives in responsibilities. Job Responsibility - Performs admissions, registration and scheduling activities. Obtains necessary demographic and insurance information and enters data into computer system, which may include patients on Medicare/Medicaid; - Verifies patient insurance coverage and other related data. Obtains patient insurance authorization required for services; Documents authorization approvals and denials in computer systems; may financially screen patients, evaluating and assessing all self-pay patients pre-registered or inpatient/outpatient, to establish method of payment; Informs and counsels patient/patient representative regarding available financial assistance; Collects money due from patient at time of service; May preform billing, receivable and related functions. - May follow through on any open self-pay accounts including monthly payment amounts for purposes of collection. - Assists and/or trains new employees as instructed by supervisor or manager. - Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification - High School Diploma or equivalent required. - 3-5 years of relevant experience, required. - Experience obtaining pre-authorizations preferred - Healthcare experience highly preferred - Experience working in a remote setting highly preferred *Additional Salary Detail The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).

