Customer Care Specialist I (Brookfield, WI)

CareSource • Brookfield, WI

298d • $35,200 - $56,200

About The Position

The Customer Care Specialist I assists members or providers with routine service inquiries. This role involves resolving member or provider routine service inquiries, which include claims processing, member benefit education, contracting and credentialing requests, eligibility inquiries, and transportation arrangements. The specialist ensures that all HIPAA and State requirements/regulations are always adhered to, researches, follows up, and resolves all open/pending issues in a timely manner to ensure member or provider satisfaction. Building and strengthening member or provider relationships by providing quality customer service is essential. The specialist must maintain knowledge and understanding of all processes and procedures, adhere to all departmental and company policies and procedures, and maintain complete and accurate documentation of all telephone and written communications. Additionally, the specialist acts as a mentor to new hire employees and performs any other job-related instructions as requested.

Requirements

• High School Diploma or equivalent is required.
• Two (2) years customer service experience is preferred.
• Customer Service experience in a call center is preferred.

Nice To Haves

• Critical thinking and listening skills.
• Decision making and problem-solving skills.
• Computer proficiency with knowledge and experience in a Windows environment.
• Typing speed of 35 words per minute (WPM).
• Strong written and communication skills.
• Professional phone etiquette.
• Proper use of grammar.
• Ability to work in a fast-paced environment.
• Adaptable to a constantly changing environment.
• Attention to detail.
• Ability to multitask.
• Ability to work independently and with a team.

Responsibilities

• Resolve member or provider routine service inquiries.
• Ensure all HIPAA and State requirements/regulations are adhered to.
• Research, follow up, and resolve all open/pending issues in a timely manner.
• Build and strengthen member or provider relationships by providing quality customer service.
• Maintain knowledge and understanding of all processes and procedures.
• Adhere to all departmental and company policies and procedures.
• Maintain complete and accurate documentation of all communications.
• Act as a mentor to new hire employees.
• Perform any other job-related instructions as requested.

Benefits

• Comprehensive total rewards package.
• Bonus tied to company and individual performance.

What This Job Offers

• Industry: Ambulatory Health Care Services
• Education Level: High school or GED