Clinical Screener

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.