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For the best candidate experience, please consider applying for a maximum of 3 roles within 12 months to ensure you are not duplicating efforts.

 


Pearl Interactive Network, Inc. is a fast growing, multi-channel contact center solutions company. In addition to performing a social mission of creating jobs for veterans, disabled veterans, people with disabilities, military spouses and people living in geographically challenged areas, we provide exceptional service to all job-seekers.  We believe that it is our duty to be an asset to our customers, to each other and to the community. We are honored that you have decided to pursue an employment opportunities with us.

As an equal employment opportunity employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.

Know Your Rights: EEO, FMLA, EPPA

Bilingual Customer Service Representative - Remote

Location: Virtual, in the U.S.

Pearl Interactive Network is seeking to hire Bilingual Customer Service Representatives Ė Remote.

The Bilingual Customer Service Representative (CSR) is responsible for responding to Medicare Part A and/or B telephone inquiries from the Medicare provider community which includes billing offices, medical societies, provider consultants, Managed Care Organizations, attorneys, etc. regarding Medicare Fee-for-Service coverage guidelines and policies covering a wide range of topics to include provider enrollment, Medicare appeals, debt recovery, claim payment information, telephone reopening requests, and general coverage for multiple provider specialties. Bilingual Spanish Reps needed. 

Why choose Pearl Interactive Network?

Join Our Team and embrace the winning Pearl Culture which promotes our employee's desires and efforts to serve our consumers, clients, and community. Our values of customer satisfaction, teamwork, a family atmosphere, quality services, respect for each other, transparency, and innovation are what make Pearl, the employer of choice. As a woman-owned, HUBZone certified social enterprise, Pearl offers hiring priority to our Veterans, Military Spouses, and their families, as well as individuals with disabilities.

Pearl offers a Competitive Compensation and Benefits package to include:

  • Rate: $19.80 per hour
  • Additional $4.22 per hour towards Health & Wellness Benefits
  • Medical, Dental, Vision, and Life Insurance
  • Paid time off, Paid holidays
  • 401K eligibility
  • Additional ancillary benefits to support your lifestyle professionally, physically, and financially through our professional development and coaching program.

Operating Hours: Monday - Friday, 9 AM - 6 PM (EST) 2 shifts to select from.

Preferred Location(s): Arkansas, Louisiana, Mississippi, Texas, Oklahoma, Colorado

Technical/Equipment Requirements:

  1. Broadband internet connection with a minimum upload speed of 20 Mbps and download speed of 5 Mbps. No Satellite Connections. Test your network at speedtest.com to verify before you apply.
  2. Ethernet cable access. Wi-Fi-only connectivity, prohibited.
  3. Private and secure workspace within your home. Away from noise and distractions.
  4. Computer equipment, monitor(s), and headset provided.

Job Duties:

  • Respond to each customerís need and request and ensure each customerís encounter is positive and productive.
  • Access multiple systems to research customer problems and record inquiry types.
  • Research CMS and company websites to provide knowledge and education to customers on additional resources which can be used in the future.
  • Access the IVR and Internet Portal systems as needed to help educate customers on self-service options that are available to them.
  • Review claims processing systems to identify specific claim edits and audits applied on claims. Analyze claim edits and audits to determine reasons for claim denials.
  • Review debt recovery systems to troubleshoot reasons for pending accounts receivables and the generation of overpayment demand letters. Review and analyze data to determine reasons for overpayments.
  • Review local medical coverage and national medical coverage policies in order to troubleshoot reasons for claim denials and reductions.
  • Review other systems to address and determine a resolution to other customer issues to include pending appeals, aged claims, and Medicare Secondary Payer.

Job Requirements:

  • High School diploma, GED, or equivalent. Some college education is preferred.
  • Minimum 1-year experience in a call center, customer focus, or claims processing in the insurance industry or medical coding, preferred.
  • Strong problem solving and decision-making skills
  • Good listening and strong verbal communication skills
  • Fluency in Spanish and English (verbal and written), required.
  • Working on a PC in a Windows or similar environment.

The above statements are intended to describe the general nature and level of the work being performed by people assigned to this work. This is not an exhaustive list of all duties and responsibilities. Pearl management reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.

Background/Suitability Check, Drug Screening, and Skills Assessments Required

Consistent with E.O. 14042, absent a legally required accommodation relating to a disability, including medical condition, or a sincerely held religious belief, employees must be fully vaccinated for COVID-19 as a condition of employment. This means a COVID-19 vaccination is a qualification standard for the job related to safety for all employees assigned to work on a covered contract.

Skills/Qualifications/Keywords: Action Oriented/Tenacity, Dealing with Ambiguity, Compassion, Customer Focus, Ethics and Values, Functional and Technical Skills, Informing, Integrity and Trust, Listening, Priority Setting, Problem Solving, MS Outlook, and Office Skills, Leadership Team, People Skills, Diversity, Professionalism, Organization, Team Oriented, Learning, Flexibility, Effective Communication.

Pearl Interactive Network, Inc. is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, veteran status, disability status, genetics, or sexual orientation, and gender identity.

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