Customer Care Specialist I (Must live in Ohio)
About The Position
The Customer Care Specialist I assists members/beneficiaries or providers with routine service inquiries. This role involves resolving inquiries related to claims processing, member benefit education, contracting and credentialing requests, eligibility inquiries, and transportation arrangements. The specialist must ensure adherence to all HIPAA, State, and Federal requirements and regulations, and maintain knowledge of all processes and procedures. Additionally, they are responsible for researching, following up on, and resolving open/pending issues to ensure member or provider satisfaction, building and strengthening relationships through quality customer service, and maintaining complete and accurate documentation of all communications. The role also includes mentoring new hires and performing other requested job-related instructions.
Requirements
- High School Diploma or equivalent is required
- 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
- Works well under pressure
- 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
- Must live in Ohio
Nice To Haves
- Two (2) years customer service experience is preferred
- Customer Service experience in a call center is preferred
Responsibilities
- Resolve member/beneficiaries or provider routine service inquiries; examples include claims processing, member benefit education, contracting and credentialing requests, and when applicable, eligibility inquiries, and transportation arrangements
- Ensure all HIPAA, State and/or Federal requirements/regulations are always adhered to
- Research, follow up, and resolve all open/pending issues in a timely manner to ensure member or provider satisfaction
- 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 of telephone and written communications
- Act as a mentor to new hire employees
- Perform any other job related instructions, as requested
Benefits
- Substantial and comprehensive total rewards package
- Bonus tied to company and individual performance
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
