Top 45 Mcs Jobs in San Juan, Pr

Representante De Sevicios I - CS - Plaza Las Americas
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- High school diploma or GED
Billing Specialist - Guaynabo PR
Alivia Health —Guaynabo, PR
- Full-time
- Mid-level
- High school diploma or GED
Quick Apply
Coordinador(a) Clinico
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- HIPAA
- English
Product Development Engineer
Weil Group, Inc —Juncos, PR
- Temporary
- Bilingual
- Background check
- Bachelor's degree
Quick Apply
6d
Coordinador)a) de Promocion de Salud y Bienestar
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Office
Representante de Servicio al Cliente I - CC - copy
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Rotating shift
- Spanish
- English
- Mid-level
Tecnico de Querellas y Apelaciones
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Research
Técnico De Querellas y Apelaciones
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Research
13d
Especialista De Comunicaciones A Proveedores
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Extended hours
- Spanish
- English
- Mid-level
12d
Tecnico(a) De Programacion De Necesidades Especiales
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Administrative experience
Lider de Asuntos de Gobierno
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Analysis skills
6d
Especialista en Facturación - Guaynabo PR
Alivia Health —Guaynabo, PR
Quick Apply
Especialista de Relaciones con la Red de Medicos Primarios (PCPs)
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Mid-level
Evaluador(a) De Perfiles De Salud
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Mid-level
Representante de Manejo de Prima
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Customer service
- English
Representante De Ventas - Carolina
MCS HEALTHCARE HOLDINGS, LLC —Carolina, PR
- Spanish
- English
- Mid-level
- Health insurance
Coordinador(a) De Ventas A Agentes Independientes
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Office
Gerente De Proyectos
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Computer Science
- English
- Health insurance
Tecnico(a) de Alcance Comunitario
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- Customer service
- English
13d
Educador En Salud
MCS HEALTHCARE HOLDINGS, LLC —San Juan, PR
- Spanish
- English
- Mid-level
- Wellness program

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Representante De Sevicios I - CS - Plaza Las Americas

MCS HEALTHCARE HOLDINGS, LLC -
San Juan, PR

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Job Details

Qualifications

English
Typing

Full Job Description

Representante De Sevicios I - CS - Plaza Las Americas

Regular

Non-Exempt

GENERAL DESCRIPTION:

The Customer Service Representative I – SC is responsible for assisting customers and prospects with information about the company's products and services. They address and clarify any questions from beneficiaries who have concerns. Resolves service needs by following established operational processes and service guidelines and documents the services provided to ensure the continuity of offerings by the Service Center.

ESSENTIAL FUNCTIONS:

Handles and resolves service requests from customers and prospects, including inquiries about the eligibility of policyholders and dependents, cancellation letters, changes to Independent Practice Associations (IPAs) and Primary Care Physicians (PCPs), issuance of duplicate cards, coverage certifications, beneficiary value programs, utility collections, premium collections, and reimbursement requests, among others.
Prepares coverage certifications and letters of non-covered services, among others, according to the policyholder’s request.
Maintains updated the database regarding policyholder demographics information in the systems.
Registers visitors in the system and evaluates each member's service situation before interaction to identify areas that need improvement and to determine the appropriate course of action, adhering to established standards such as wait times, service quality, transaction accuracy, and error rates.
Logs cases in the system or applications, works the cases received through the Customer Relationship Management (CRM) case referral tool, keeps customers informed of the status, and notifies them of the outcome of the request. Documents in the system the steps taken to complete the service cycle, complying with documentation parameters and preparing transaction reports.
Handles calls from the Call Center of the company's different lines of business received from members who have questions, concerns, or discomfort about complex situations regarding benefits, processes, and coverage, among others. Ensures that any service cycle is completed for calls that could not be resolved during the first contact or for which there was a commitment to follow up with the customer.
Refers to the corresponding unit the complaints received from policyholders, following the established protocol.
Receives, documents, solves, and/or channels service requests from other departments to support customer retention, ensuring a response is received.
Support other departments by completing Health Risk Assessment (HRA) calls.

ADDITIONAL FUNCTIONS:

Must comply fully and consistently with all company policies and procedures, with local and federal laws as well as with the regulations applicable to our Industry, to maintain appropriate business and employment practices.
May carry out other duties and responsibilities as assigned, according to the requirements of education and experience contained in this document.

MINIMUM QUALIFICATIONS:

Education and Experience: Bachelor’s Degree from an accredited institution. At least six (6) months of experience performing duties in a similar position in Customer Service areas, preferably in a Call Center in the Health Insurance Industry.

Education and Experience: Sixty to sixty-four (60-64) college credits, equivalent to two (2) years of study or an Associate’s Degree. At least one (1) year of experience working in Customer Service areas, preferably in a Call Center in the Health Insurance Industry.

Education and Experience: High School Diploma. At least two (2) years of experience working in Customer Service areas, preferably in a Call Center in the Health Insurance Industry.

“Proven experience may be replaced by previously established requirements.”

Certifications / Licenses: N/A

Other: Customer Service oriented, keyboard and telephone etiquette knowledge.

Languages:

Spanish – Intermediate (comprehensive, writing and verbal)
English – Intermediate (comprehensive, writing and verbal)

“We are an Equal Employment Opportunity Employer and take Affirmative Action to recruit Protected Veterans and Individuals with Disabilities.”

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Refine Your Search

mcs jobs in san juan, pr

Representante De Sevicios I - CS - Plaza Las Americas

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Coordinador)a) de Promocion de Salud y Bienestar

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Coordinador(a) De Ventas A Agentes Independientes

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