Call Center Specialist

Description

We are looking for bilingual (English/Spanish) Call Center Specialists to support members in a fast-paced health insurance environment in Las Vegas, NV. This contract opportunity with permanent potential is ideal for someone who can manage complex customer concerns with professionalism, empathy, and accuracy while helping members navigate claims and benefit-related questions. The person in this role will serve as a key point of contact for escalated issues and will work closely with internal teams to ensure timely, informed resolutions.

Responsibilities:

- Address elevated member concerns and service complaints, taking ownership of each issue through resolution.

- Support claims-related inquiries and processing activities while ensuring accurate handling of case details.

- Partner with the benefits enrollment team to research and resolve questions involving eligibility, reported hours, and co-premium matters.

- Communicate with members in a patient and empathetic manner, providing clear guidance on sensitive or complex situations.

- Investigate unusual or complicated cases, using sound judgment to determine appropriate next steps and solutions.

- Maintain up-to-date knowledge of health plan offerings, service guidelines, and policy details to deliver reliable information.

- Record customer interactions, actions taken, and final outcomes thoroughly in the appropriate system.

- Protect confidential member information and follow all applicable regulations, internal policies, and compliance standards.

Requirements

- Bilingual fluency in English and Spanish is required.

- Prior experience in a high-volume call center setting is required, preferably within healthcare, insurance, or a similar service-driven industry.

- Hands-on knowledge of claims inquiries, claims review processes, complaints, appeals, medical specialties, and fee schedule concepts is required.

- Strong verbal and written communication skills with the ability to explain detailed information clearly and compassionately.

- Ability to handle multiple member issues at once while maintaining accuracy, organization, and attention to detail.

- Effective problem-solving skills, especially when addressing complicated eligibility and claims-related questions.

- Experience supporting union populations is preferred.

- Familiarity with Salesforce and intermediate Microsoft Office skills, including Word, Excel, and Outlook, are preferred.

PLEASE NOTE - This job is 100% work from home, however you must live in Las Vegas, NV.

Talent Match®

Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app ()  and get 1-tap apply, notifications of AI-matched jobs, and much more.

All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit  for more information.

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