Consumer Service Operations Representative

Humana Remote
consumer service operations operations representative consumer service operations operations representative virtual language call center english pm
May 13, 2023
Tampa, FL


The Consumer Service Operations Representative is responsible for the daily activities across multiple service functions area. The Consumer Service Operations Representative performs varied activities and moderately complex administrative/operational/customer support assignments. Performs computations. Typically works on semi-routine assignments.


The Consumer Service Operations Representative is responsible for handling a large volume of incoming calls from sales agent (internal and external) licensed to sell CarePlus and Humana in the State of Florida. The Consumer Service Operations Representative is also responsible for providing first-call resolution and exceptional customer service experience in a fast-paced call center environment. The responsibilities include but are not limited to enrollment verification, eligibility verification, pre-screen, and initiating expedited referrals in the application for Federal and State assistance programs. Provides plan and benefits information to callers, view appointments and sales agent certification inquiries. As a Consumer Service Operations Representative you are expected to follow all regulatory and compliance guidelines implemented by state and federal government or the plan.


Required Qualifications                                                                                             

  • Fully bilingual English/Spanish. Must be able to speak, read and write in both languages without limitations or assistance.  If selected for the position, you will be required to take a Language Proficiency Assessment in English/Spanish.
  • 3 years of customer service experience, including typing/data entry.  This is an inbound call center type environment position, using a headset, handling a large volume of continuous incoming calls with scheduled breaks and lunch.
  • Proficient in Microsoft Office Outlook and Word
  • Excellent verbal, listening and written communication skills.
  • Aptitude for quickly learning and navigating new technology, systems and applications.
  • Must be able to live near and travel to the closest CarePlus Health Plan facility as needed. Orlando, Tampa, and South Florida.
  • Schedule work hours are from 9:00 am to 6:00 pm eastern time, Monday through Friday. During open enrollment (15 Oct – 7 Dec), we extend our hours from 9:00 am to 7:00 pm, Monday through Friday and 9:00 am to 5:00 pm on Saturdays. Extended hours will be covered on a rotating basis.

Preferred Qualifications

  • Associate or bachelor's degree
  • Previous healthcare experience
  • Previous inbound and/or outbound call center experience

Additional Information 

  • Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. 

Humana Perks:

Full time associates enjoy:   

  • Medical, Dental, Vision and a variety ofothersupplemental insurances   
  • Paid time off(PTO)& Paid Holidays
  • 401(k) retirement savings plan
  • Tuitionreimbursement and/or scholarships for qualifying dependent children.
  • And much more!  

Social Security Task:

Alert: Humana values personal identity protection.  Please be aware that applicants being considered for an interview will be asked to provide a social security number, if it is not already on file.  When required, an email will be sent from [email protected] with instructions to add the information into the application at Humana’s secure website.  


Virtual Pre-Screen:

As part of our hiring process for this opportunity, we will be using exciting virtual pre-screen technology called Modern Hire to enhance our hiring and decision-making ability. Modern Hire allows us to quickly connect and gain valuable information for you pertaining to your relevant skills and experience at a time that is best for your schedule. If you are selected for a virtual pre-screen, you will receive an email and text correspondence inviting you to participate in a Modern Hire interview.  In this virtual pre-screen, you will receive a set of questions to answer. You should anticipate this virtual pre-screen to take about 10-15 minutes.

Work-At-Home Requirements

  • WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a home office. Associates or contractors who live and work from home in the state of California will be provided payment for their internet expense.
  • A minimum standard speed for optimal performance of 25x10 (25mpbs download x 10mpbs upload) is required. 
  • Satellite and Wireless Internet service is NOT allowed for this role.
  • A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

Scheduled Weekly Hours


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