Bilingual Medicaid Inbound Call Center Rep

Humana Remote
bilingual medicaid call center medicaid calls bilingual representative customer service assignments language usa delivering phone calls
March 22, 2023
San Antonio, TX


Humana is continuing to grow nationwide! We have 28 new Bilingual Medicaid Inbound Contact Representative openings that will have the pleasure of taking inbound calls from our Florida Medicaid Members and provide excellent service and support. These roles will be 100% work at home and are an amazing opportunity to join a Fortune 100 company that continues to expand and grow across the USA!!

A Bilingual Medicaid Inbound Contacts Representative 2 represents Humana by addressing incoming telephone, digital, or written inquiries from Humana Medicaid members asking about benefits, PCP changes, authorizations, pharmacy or transportation needs.

These front-line member contact center advocates strive to provide a resolution *or* a pathway to a resolution on each member call, while still upholding our Perfect Experience Way Guideposts and delivering on our Human Care mindset every day. These simple customer service principles are foundational in everything we do and apply not only to the people we serve, but to our internal teammates, as well.
• Start with Gratitude
• Do the Next Right Thing
• Root for Positivity
• Go the Distance


Overview of Job Duties / Functions:

The Bilingual Medicaid Inbound Contact Representative 2 performs varied activities and moderately complex administrative, operational, and customer support assignments; inputting detailed data in various systems while typically working on semi-routine assignments and phone calls.

The Bilingual Medicaid Inbound Contact Representative 2 addresses member needs which may include complex benefit questions, resolving issues, educating members, and delivering best-in-class member experiences.

  • Handles 40-50 inbound calls daily from members in a fast-paced inbound call center environment and, at times, back-to-back phone calls.
  • Documents accurate details of inquiries, comments or complaints, transactions or interactions and records all actions taken in accordance to the request or questions being asked.
  • Escalates unresolved and pending member grievances and appeals. Decisions are typically focused on detailed processes and area/department policies and methods for completing assignments.
  • Works within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction.
  • Follows standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion.
  • Participates in daily team chats, accesses a knowledge-based database (Mentor) on every call, and reads emails daily to stay on top of alerts, trainings, and all Medicaid updates/changes.



    Required Work Schedule:

    • Virtual Training will start day one of employment and runs the first 7 weeks with a schedule of 8:00 am – 4:30 pm EST, Monday - Friday. This schedule continues for 120 days.
    • Attendance is vital for success, so no time off is allowed during training or within your first 60 days, except for Humana observed / paid holidays.
    • Following your first 120 days appraisal period, you will be assigned to work an 11:30 am - 8:00 pm shift, EST, Monday – Friday, subject to change based on business needs.
    • Some weekends and overtime may be required based on business needs.

    Required Qualifications:

    • Minimum 1 year of customer service experience
    • MUST be Bilingual in English and Spanish (see Additional Information below)
    • *Residency within the continental USA*
    • Demonstrated experience with providing exceptional customer service and attention to details while listening on calls.
    • Prior experience managing multiple or competing priorities, including use of multiple computer applications simultaneously.
    • Prior experience effectively communicating with customers verbally and listening to their needs.
    • Accurate and complete documentation of member needs, inquiries, or questions during calls within multiple systems.

    Preferred Qualifications:

    • Associate's or Bachelor's Degree
    • Prior inbound call center or related customer service experience
    • Prior understanding and awareness of Contact Center metrics and goals
    • Prior healthcare experience, in particular, Medicaid Insurance Plans
    • Proficiency with Microsoft Office applications, particularly Outlook, Word and MS Teams

    Additional Information

    Please be advised, any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government.  Candidates must be tested in ALL languages listed on the description.

    Work at Home Guidance

    To ensure Home or Hybrid Home/Office associates’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:

    • At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested.
    • Satellite, cellular and microwave connection can be used only if approved by leadership.
    • Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
    • Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
    • Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

    Application Information

    Please remember to include a copy of your resume!

    As part of our hiring process for this opportunity, we will be using an exciting interviewing technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.  If you are selected for a first-round interview, you will receive an email correspondence (please be sure to check your spam or junk folders often to ensure communication isn’t missed) inviting you to participate in a Modern Hire interview. In this interview, you will listen to a set of interview questions over your phone, and you will provide recorded responses to each question. You should anticipate this interview to take about 15 to 30 minutes. Your recorded interview will be reviewed, and you will subsequently be informed if you will be moving forward to next round of interviews.

    This is a remote position


    Scheduled Weekly Hours


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