Member Flex Guide, Bilingual – English/Spanish

JobtailorWorkFromHome

Stellenbeschreibung:

Responsibilities

Engage fluently in English and Spanish across inbound/outbound calls, SMS, chat, secure messaging, email, and video
Translate and simplify complex healthcare, insurance, and medical terms into clear, culturally sensitive guidance
Assist members in finding language-congruent providers and scheduling appointments
Conduct proactive outreach about preventive screenings, clinical programs, and benefit utilization
Identify situations requiring clinical escalation and collaborate with medical staff and bilingual teammates
Use an AI Guide Assistant to access benefit information and deliver accurate answers
Maintain complete and accurate interaction documentation in internal systems
Adhere to HIPAA, regulatory compliance guidelines, and privacy policies
Meet productivity and quality standards, including resolution rates, service quality metrics, and handle times
Flex between inbound support, outbound campaigns, and cross-functional programs based on business demands
Adapt to changing workflows, technology platforms, and policy updates
Incorporate coaching and feedback from leadership for professional development

Requirements

Professional, native-level oral and written fluency in both English and Spanish is required
1+ years of experience in a high-volume customer-facing role, contact center, or fast-paced healthcare environment
Exceptional interpersonal skills and emotional intelligence, with ability to connect across diverse communities and de-escalate sensitive situations
Ability to explain intricate insurance and medical concepts clearly in both languages
Comfort working alongside AI-powered tools and navigating multiple software platforms simultaneously
Demonstrated ability to pivot between shifting priorities and operate effectively in ambiguous environments
Willingness to work variable hours based on operational needs and seasonal demand
Background in Medicare Advantage, health insurance, or HIPAA-regulated medical environments
Prior experience in a dedicated bilingual customer service or medical translation role
Proven stress-management techniques for fast-paced or emotionally demanding settings

Core Competencies

Fluent in English and Spanish, with the ability to translate complex healthcare and insurance concepts into clear guidance. Experienced in high-volume customer service roles, adhering to HIPAA regulations, and utilizing AI tools for effective communication and documentation.