CarePlus Bilingual Call Center Representative - 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: October 26, 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.

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.

Associate or Bachelor’s degree Previous call center