Job Details

Job Summary

We are seeking a friendly, detail-oriented Bilingual Customer Service Representative (English/Spanish) to support members and providers with questions related to health and wellness benefit claims. This role serves as a key point of contact, ensuring accurate information, timely resolution, and a positive customer experience while upholding compliance and service standards.

Key Responsibilities

Respond to inbound phone calls, emails, and/or portal inquiries from members and providers in English and Spanish

Answer questions related to health and wellness benefit claims, eligibility, coverage, and plan provisions

Research and explain claim status, payments, denials, and required documentation

Accurately document all interactions in claims and customer service systems

Coordinate with internal departments (claims processing, eligibility, billing) to resolve issues

Educate members on benefit usage and claims procedures in a clear, empathetic manner

Adhere to HIPAA, company policies, and service-level standards

Escalate complex or unresolved issues as appropriate

Required Qualifications

Fluent in English and Spanish (spoken and written)

High school diploma or equivalent (Associate's degree or higher preferred)

1+ year of customer service experience (healthcare, insurance, or benefits experience a plus)

Strong verbal communication and active listening skills

Basic computer proficiency and ability to navigate multiple systems

Strong attention to detail and problem-solving skills

Ability to handle sensitive information with professionalism and confidentiality

Preferred Qualifications

Experience working with health insurance, TPA, or wellness benefit claims

Familiarity with medical terminology and explanation of benefits (EOBs)

Call center or member services experience

Skills & Competencies

Customer-focused mindset

Clear and professional communication

Time management and organization

Empathy and patience when handling member concerns

Ability to work independently and as part of a team

For immediate consideration apply today.

Equal Opportunity Employer / Disabled / Protected Veterans

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The pay transparency policy is available here:
English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.


We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.