Spanish Customer Service Representative

Our client, a major PBM (Pharmacy Benefit Services) entity owned by 20 non‑profit health plans serving >33 million members and benefits manager of government programs including Medicare and Medicaid, seeks an accomplished Spanish Customer Service Representative
.

• START DATE:
  Mon, Mar 09, 2026 || 20 Openings
• CLIENT IS HIRING CANDIDATES CALIFORNIA RESIDENTS ONLY.
• LOCATION: 100% REMOTE/ WORK FROM HOME
• DURATION: 6 months assignment with potential of extension
• WORK
  
  SHIFTS:
  
  Client Ops are 24/7. Hires would be spread across shifts, so candidates must be flexible to any of below shifts / schedules [
  Candidates must be available to work either both weekend days OR one weekend day
  ].
• SHIFT /
  
  WORKING HOURS:
  
  8 hours between 6am – 10pm Pacific || No Graveyard Shift || Can be any 5 days of the week (including one weekend)
• Training: 5 Weeks Total || (3 weeks) 8:00am - 5:00pm || (2 Weeks) 8:00am – 4:30pm (Success Lab)
• TIME-OFF POLICY:
  No time-off during Training || No absences in first 90 days preferred

• Equipment will be provided.
• Candidate MUST have reliable Internet connection- (No WI-FI) ethernet connection At least 150
  
  MBPS(Uninterrupted).
• Candidate MUST have a reliable home‑office environment.
• Client provides 2-meter LAN cable for endpoint connectivity from modem / router to laptop.
• Video Camera:
  Required to be on during Training / Team meetings etc.
• Work From Home location: be quiet and free from interruptions.

• Answering incoming calls related to eligibility, benefits, claims and authorization of services from members or providers.
• Responsibilities also include administration of intake documentation into the appropriate systems.
• Researches and articulately communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality.
• Resolve customer administrative concerns as the first line of contact - this may include claim resolutions and other expressions of dissatisfaction.
• Comprehensively assembles and enters patient information into the appropriate delivery system to initiate the EAP, Care and Utilization management programs.
• Educates providers on how to submit claims and when/where to submit a treatment plan.
• Informs providers and members on Client’s appeal process.
• Links or makes routine referrals and triage decisions not requiring clinical judgment.
• Provides information regarding Client’s in‑network and out‑of‑network reimbursement rates and states multiple networks to providers.
• Refers callers requesting provider information to Provider Services regarding Client’s professional provider selection criteria and application process.
• Refers patients / EAP clients to Client’s Care Management team for a provider, EAP affiliate, or Facility.

• At least High School diploma or equivalent (GED).
• MUST BE PROFICIENT IN SPANISH LANGUAGE.
• Candidate must have 3-5 years of Customer Service experience handling high call volume within Healthcare or Pharma Industry.
• Typing speed of 40+ WPM with strong written / verbal communication skills, must be able to talk and type simultaneously.
• Flexible and comfortable with change in the ever-changing environment of customer service.
• Ability to maneuver through various computer platforms while verifying information on phone calls.

I’d love to talk to you if you think this position is right up your alley, and assure prompt communication, whichever direction. If you are looking for rewarding employment and a company that puts its employees first, we’d like to work with you.

Recruiter Name:
Jatin Rattan