Spanish Language advisor
Location: Thane
Employment Type: Full-Time
Experience: 6+ Months
Industry: Insurance / Customer Service
Role Overview
The Member & Provider Support Advocate is responsible for delivering high-quality voice support to US health plan members and contracted providers. This role focuses on resolving inquiries related to benefits, eligibility, claims, authorizations, and general plan support while maintaining strict adherence to healthcare regulatory standards.
This is a voice-intensive, customer-centric role requiring strong communication skills, accuracy, empathy, and professionalism in a compliance-sensitive environment.
Key Responsibilities
1. Member & Provider Support
- Handle inbound and outbound calls for US health plan members and providers.
- Address inquiries related to benefits, eligibility, claims status, ID cards, authorizations, and billing.
- Provide clear, accurate explanations of plan policies and next steps.
- Ensure complete and precise documentation of all interactions within system platforms.
- Deliver empathetic, respectful, and solution-focused service.
2. Issue Resolution & Case Management
- Strive for first-call resolution wherever possible.
- Identify and escalate complex, regulatory-sensitive, or high-risk issues appropriately.
- Track and follow up on pending cases to ensure timely closure.
- Meet defined service level agreements (SLAs) and productivity expectations.
3. Compliance & Quality
- Adhere strictly to HIPAA and healthcare data privacy regulations.
- Maintain audit-ready documentation at all times.
- Meet Quality Assurance (QA), accuracy, and call-handling benchmarks.
- Participate in training, coaching sessions, and calibration reviewsRequired Experience & Qualifications
- Mandatory Requirements
- 6 months to 1 year of US Customer Service experience (voice-based).
- Minimum qualification: High School Diploma (or equivalent) is mandatory
- Experience supporting US customers in a structured, process-driven environment.
- Clear, neutral American English accent with strong verbal communication skills.
- Ability to handle high-volume inbound calls professionally.
- Strong system navigation and documentation capabilities.
Preferred Qualifications
- Graduates preferred.
- Exposure to US Healthcare operations (Medicare Advantage, Commercial, or Medicaid).
- Experience in Member Services or Provider Services.
- Basic knowledge of healthcare terminology.
- Familiarity with platforms such as Facets, Salesforce, or similar systems.Core Competencies
- Strong communication and active listening skills
- High empathy and service orientation
- Attention to detail and accuracy
- Compliance-driven mindset
- Time management and SLA adherence
- Professional composure during challenging interactions
Work Environment & Expectations
- Voice-dominant, high-volume operational environment
- Flexibility during peak business cycles (e.g., enrollment periods)
- Mandatory completion of HIPAA and compliance certifications
- Continuous performance monitoring and coaching
Career Progression Path
- Senior Support Advocate
- Subject Matter Expert (SME)
- Quality Analyst
- Team Lead/Quality Lead – Member & Provider Services
- Operations Supervisor/Manager
How to Apply
Interested candidates can share their updated resume at:
Email: [email protected]
Contact: 9431 9431 96/ 9599343134
Pay: ₹60,000.00 - ₹70,000.00 per month
Work Location: In person
