Customer Service Jobs in Puerto Rico

Description The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation and communication of medical services and/or benefit administration determinations. The Utilization Management Nurse 2 work assignments ..

Description The Claims Review Representative 3 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative 3 performs advanced ..

... Contacts Representative 3 performs advanced administrative/operational/customer support duties that require independent ... a timely basis to achieve service and quality standards. Decisions are ... inbound call center or related..

... Inbound Contact Representative 2 addresses customer needs which may include complex ... it. Escalates unresolved and pending customer grievances. Decisions are typically focused ... Qualifications Minimum 2 years of..

Description The Supervisor, Consumer Service Operations is responsible for the ... the daily activities across multiple service functions area. The Supervisor, Consumer ... functions area. The Supervisor, Consumer Service Operations..

... Medicare Members and provide excellent service and support. These roles will ... Inbound Contact Representative 2 addresses customer needs which may include complex ... it. Escalates unresolved and pending..

Job Information Humana Call Quality Professional 1 (Bilingual English/Spanish) in San Juan Puerto Rico Description The Call Quality Professional 1 monitors and evaluates the quality of inbound and/or outbound customer service ..

... delivers, and manages products for customer use. The Product Manager 2 ... developing products to meet specific customer needs and achieve specific cost ... efficacy of products and uses..

Job Information Humana Outbound Contact Representative 3 (FULLY Bilingual English/Spanish) San Juan, Puerto Rico in San Juan Puerto Rico Description The Outbound Contacts Representative 3 represents the company by making outbound ..

... Medicare Members and provide excellent service and support. Currently these roles ... Inbound Contact Representative 2 addresses customer needs which may include complex ... it. Escalates unresolved and pending..

Description Do you enjoy helping those in need? Do you love researching, analyzing medical documents to determine if something was missed? Have you ever considered yourself a detective for medical claims ..

Description The Credentialing Assistant 3 obtains and reviews documentation to determine status in a health plan. The Credentialing Assistant 3 performs advanced administrative/operational/customer support duties that require independent initiative and judgment. ..

... varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically ... as a member advocate, addressing customer needs, which may include acting ... Work Environment: This is a..

Job Information Humana Call Quality Professional 2 in San Juan Puerto Rico Description The Call Quality Professional 2 monitors and evaluates the quality of inbound and/or outbound customer service calls, call ..

Description The Claims Review Representative 3 makes appropriate claim decision based on strong knowledge of claims procedures, contract provisions, and state and federal legislation. The Claims Review Representative 3 performs advanced ..

Description The Quality Assurance Technician develops and implements programs to establish and maintain quality standards of existing products and services, as well as developing programs to focus employees on the quality ..

... and Resolution Representative 2 address customer needs which may include complex ... it. Escalates unresolved and pending customer inquiries How we Value You ... Research and Resolution Supervisor, CCM..

Description The Supervisor, Grievances & Appeals manages client medical denials by conducting a comprehensive analytic review of clinical documentation to determine if an appeal is warranted. The Supervisor, Grievances & Appeals ..

Description The Claims Processing Representative 3 reviews and adjudicates complex or specialty claims, submitted either via paper or electronically. The Claims Processing Representative 3 performs advanced administrative/operational/customer support duties that require ..

... Appeals Representative 3 performs advanced administrative/operational/customer support duties that require independent ... in English 1-3 years of customer service experience 1-3 years prior experience ... office (Satellite and Wireless..

Description The Supervisor, Inbound Contacts represents the company by addressing incoming telephone, digital, or written inquiries. The Supervisor, Inbound Contacts works within thorough, prescribed guidelines and procedures; uses independent judgment requiring ..

... and Resolution Representative 2 address customer needs which may include complex ... it. Escalates unresolved and pending customer inquiries How we Value You ... Research and Resolution Supervisor, CCM..

... Appeals Representative 3 performs advanced administrative/operational/customer support duties that require independent ... on testing 1-3 years of customer service experience 1-3 years prior experience ... office (Satellite and Wireless..