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.