CarePlus Bilingual Call Center Rep - Puerto Rico

Become a part of our caring community   The CarePlus Medicare Call Center Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries from Medicare members. The CarePlus Medicare Call Center Rep performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. In this position, you will strive to provide our CarePlus Medicare members with a resolution or pathway to resolution on each call, while providing a perfect call experience. Among other responsibilities, you will address member needs which may include complex benefits questions, resolving issues, and educating our members. You will handle 20 to 35 inbound calls daily from Medicare members with a focus on high-quality service and one-call resolution. This is a high-volume call center setting, which may be stressful at times. As a CarePlus Medicare Call Center Rep, you will receive inbound calls; 60% to 70% of them require you to place outbound calls to physicians, DME vendors, pharmacies or other entities to help members. You will accurately record details of inquiries, comments or complaints, transactions, or interactions, and take appropriate action accordingly. Decisions are typically focused on interpretation of area / department policy and methods for completing assignments. You will be responsible for escalating unresolved and pending customer grievances. You will work under minimal direction within defined parameters to identify work expectations and quality standards but will have some latitude over prioritization / timing . You will follow standard policies / practices that allow for some opportunity for interpretation / deviation and / or independent discretion. Requires strong emotional intelligence to proactively provide solutions, ensuring the member's utmost health and safety. Use your skills to make an impact Required Work Schedule Projected start date: August 31, 2026. Virtual training will start on day one of employment and runs for the first 7 weeks, working any shift between the hours of 8:00 AM and 8:00 PM Eastern Time (9:00 AM to 9:00 PM AST during Daylight Saving Time), Monday through Friday , based on business needs. Following training, you will be assigned to an 8-hour shift between the hours of 8:00 AM and 8:00 PM Eastern Time (9:00 AM to 9:00 PM AST during Daylight Saving Time), Monday through Friday.  You must have the flexibility to work weekends, holidays and/or mandatory overtime, based on business needs. This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role.  You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities. Required Qualifications You must currently live in the Commonwealth of Puerto Rico. You must be fully Bilingual in English / Spanish with the ability to speak, read, and write in both languages without limitations or assistance . If selected for the position, you will be required to take a Language Proficiency Assessment in English / Spanish (see Language Proficiency Testing below). You have 1+ years of customer service experience You have demonstrated experience with providing strong customer service, using effective communications skills and strong attention to detail while also actively listening to their needs. You must have prior experience managing multiple or competing priorities, including use of multiple computer applications / systems simultaneously. You must be proficient with Microsoft Office applications, particularly Outlook and Teams Ability to maintain a professional demeanor, practicing strict confidentiality for all sensitive information. You  must take strong initiative with the ability to adapt to change quickly and be empathetic. Preferred Qualifications Associate or Bachelor’s degree Previous call center or related customer service experience Previous experience with case management processes Previous healthcare experience Pay Rate IMPORTANT : While you see an estimated pay range reflected in this job posting, the pay rate for this position is $15.39 per hour and is non-negotiable . 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: Must have the ability to provide a high-speed DSL or cable modem for a home office. A download speed of 25 Mbps and an upload speed of 10 Mbps is required. Associates in this role are required to be hard-wired to their internet connection. Wireless, satellite, cellular, and microwave connections are NOT permitted. Must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Please note this position allows you to work at home until further notice; there is a possibility of this opportunity returning to a physical office at a future date, to be determined by leadership. Language Proficiency Testing Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.   Additional Information   **PLEASE MAKE SURE YOU ATTACH YOUR RESUME ( IN ENGLISH, PLEASE ) TO YOUR APPLICATION (PDF OR WORD FORMAT) **    Selection Process Time off and scheduled obligations during the first 120 days will be evaluated as part of the selection process. Training and onboarding for this position is critical for associate development. Interview Process As part of our hiring process for this opportunity, we will be using technology called HireVue to enhance our hiring and decision-m