Spanish Language advisor

Location: Thane
Employment Type: Full-Time
Experience: 6+ Months
Industry: Insurance / Customer Service

Role Overview
The Member & Provider Support Advocate is responsible for delivering high-quality voice support to US health plan members and contracted providers. This role focuses on resolving inquiries related to benefits, eligibility, claims, authorizations, and general plan support while maintaining strict adherence to healthcare regulatory standards.
This is a voice-intensive, customer-centric role requiring strong communication skills, accuracy, empathy, and professionalism in a compliance-sensitive environment.
Key Responsibilities
1. Member & Provider Support
- Handle inbound and outbound calls for US health plan members and providers.
- Address inquiries related to advantages, eligibility, claims status, ID cards, authorizations, and billing.
- Provide clear, accurate explanations of plan policies and next steps.
- Ensure complete and precise documentation of all interactions within system platforms.
- Deliver empathetic, respectful,



and solution-focused service.

2. Issue Resolution & Case Management
- Strive for first-call resolution wherever possible.
- Identify and escalate complex, regulatory-sensitive, or high-risk issues appropriately.
- Track and follow up on pending cases to ensure timely closure.
- Meet defined service level agreements (SLAs) and productivity expectations.

3. Compliance & Quality
- Adhere strictly to HIPAA and healthcare data privacy regulations.
- Maintain audit-ready documentation at all times.
- Meet Quality Assurance (QA), accuracy, and call-handling benchmarks.
- Participate in training, coaching sessions, and calibration reviewsRequired Experience & Qualifications
- Mandatory Requirements
- 6 months to 1 year of US Customer Service experience (voice-based).
- Minimum qualification: High School Diploma (or equivalent) is mandatory
- Experience supporting US customers in a structured, process-driven

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