CarePlus Call Center Rep - Puerto Rico

Become a part of our caring community The CarePlus Medicare Call Center Representative 2 represents the company by addressing incoming telephone, digital, or written inquiries from Medicare members. The CarePlus Medicare Call Center Rep performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. In this position, you will strive to provide our CarePlus Medicare members with a resolution or pathway to resolution on each call, while providing a perfect call experience. Among other responsibilities, you will address member needs which may include complex benefits questions, resolving issues, and educating our members. - You will handle 20 to 35 inbound calls daily from Medicare members with a focus on high-quality service and one-call resolution. This is a high-volume call center setting, which may be stressful at times. - As a CarePlus Medicare Call Center Rep, you will receive inbound calls; 60% to 70% of them require you to place outbound calls to physicians, DME vendors, pharmacies or other entities to help members. - You will accurately record details of inquiries, comments or complaints, transactions, or interactions, and take appropriate action accordingly. Decisions are typically focused on interpretation of area / department policy and methods for completing assignments. - You will be responsible for escalating unresolved and pending customer grievances. - You will work under minimal direction within defined parameters to identify work expectations and quality standards but will have some latitude over prioritization / timing. - You will follow standard policies / practices that allow for some opportunity for interpretation / deviation and / or independent discretion. - Requires strong emotional intelligence to proactively provide solutions, ensuring the member's utmost health and safety. Use your skills to make an impact Required Work Schedule - Projected start date: October 26, 2026. - Virtual training will start on day one of employment and runs for the first 7 weeks, working any shift between the hours of 8:00 AM and 8:00 PM Eastern Time (9:00 AM to 9:00 PM AST during Daylight Saving Time), Monday through Friday, based on business needs. - Following training, you will be assigned to an 8-hour shift between the hours of 8:00 AM and 8:00 PM Eastern Time (9:00 AM to 9:00 PM AST during Daylight Saving Time), Monday through Friday. - You must have the flexibility to work weekends, holidays and/or mandatory overtime, based on business needs. - This position requires learning many systems, policies, and tools, and it takes time to become proficient in the role. You must be willing to remain in this position for a period of twelve (12) months before applying to other Humana opportunities. Required Qualifications - You must currently live in the Commonwealth of Puerto Rico. - You must be fully Bilingual in English / Spanish with the ability to speak, read, and write in both languages without limitations or assistance . If selected for the position, you will be required to take a Language Proficiency Assessment in English / Spanish (see Language Proficiency Testing below). - You have 1+ years of customer service experience - You have demonstrated experience with providing strong customer service, using effective communications skills and strong attention to detail while also actively listening to their needs. - You must have prior experience managing multiple or competing priorities, including use of multiple computer applications / systems simultaneously. - You must be proficient with Microsoft Office applications, particularly Outlook and Teams - Ability to maintain a professional demeanor, practicing strict confidentiality for all sensitive information. - You must take strong initiative with the ability to adapt to change quickly and be empathetic. Preferred Qualificat