Join Our Team!
The
Clinical Screener
provides general information and
non-clinical guidance
to enrollees, including, but not limited to, Medicare, Medicaid, Commercial, and Government Health Plan enrollees, over the telephone. This role supports clinical staff through the management and follow-up of non-clinical matters and general administrative tasks.
Additionally, there are opportunities to provide services to clients in the United States
, allowing you to expand your professional experience in a dynamic and international environment.
Key Responsibilities
Follow the
Nurse Advice Line scripts
when handling different topics.
Identify customer needs, clarify information, research each situation, and provide appropriate solutions.
Manage incoming calls, validate the reason for the call, and route customers to the Nurse Advice Line or Customer Service, as appropriate.
Document enrollee interactions and transactions, including details of calls, complaints, and comments, as well as actions taken.
Take messages from incoming calls when all Registered Nurses are busy at the time of the call.
Refer unresolved customer concerns or grievances to the supervisor or designated departments for further investigation.
Schedule and coordinate
Telemedicine appointments
with medical staff.
Provide support for other Nurse Advice Line projects.
Ensure confidentiality and compliance with all state and federal regulations applicable to healthcare call centers, including
HIPAA
, as well as internal policies regarding the proper disposal of confidential information.
Immediately notify the supervisor of any exposure or disclosure of
Protected Health Information (PHI)
.
Comply with core and functional training requirements, as well as all procedures established by regulatory agencies, contractual requirements, and applicable certification standards, including, but not limited to,
URAC
.
Requirements
Minimum of
1 year of Customer Service experience
.
High school diploma
(college credits preferred).
Knowledge of
computer applications and Microsoft Office
.
Excellent
verbal, written, and reading communication skills
.
Bilingual in Spanish and English preferred
, especially for opportunities providing services to clients in the United States.
Strong customer service orientation, empathy, and a proactive attitude.
Availability to work
rotating 24/7 shifts (Monday through Sunday, including weekends and holidays)
.
Benefits
Specialized training in
customer service, healthcare regulations, and health-related topics
.
24/7 telemedicine services
.
Free
employee health and wellness programs
.
Professional growth and development opportunities
.
Paid leave.
Retirement plan
.
The opportunity to
positively impact the well-being of the population
.
Location:
Hybrid in Guaynabo or Mayagüez, PR | Remote work may be available, as applicable.
Employment Type:
Full-time | Temporary
We are an
Equal Employment Opportunity (EEOC) employer
.