Customer Care Specialist I (Healthcare/Medicare Experience, must live in Ohio)
About The Position
The Customer Care Specialist I assists members, beneficiaries, or providers with routine service inquiries, including questions about claims processing, member benefits, contracting and credentialing, and, when applicable, eligibility and transportation arrangements. The specialist researches and resolves open issues promptly, maintains accurate records of telephone and written communications, and provides quality service that builds strong member and provider relationships. The role requires adherence to HIPAA and applicable state and federal requirements, as well as departmental and company policies and procedures. The specialist maintains knowledge of processes and procedures, mentors new hires, and performs other job-related duties as requested. The position requires residence in Ohio and is performed in a general office environment.
Requirements
- High school diploma or equivalent.
- Critical thinking and listening skills.
- Decision-making and problem-solving skills.
- Computer proficiency and experience in a Windows environment.
- Typing speed of 35 words per minute (WPM).
- Strong written and communication skills.
- Ability to work under pressure and in a fast-paced environment.
- Professional phone etiquette and proper use of grammar.
- Adaptability to a constantly changing environment.
- Attention to detail and ability to multitask.
- Ability to work independently and as part of a team.
- Must live in Ohio.
- Must adhere to an assigned daily work schedule and have predictable and reliable attendance.
Nice To Haves
- Two years of customer service experience.
- Customer service experience in a call center.
Responsibilities
- Resolve routine service inquiries from members, beneficiaries, or providers, including those related to claims processing, member benefits, contracting and credentialing, and, when applicable, eligibility and transportation arrangements.
- Adhere to HIPAA and applicable state and federal requirements and regulations.
- Research, follow up on, and resolve open or pending issues in a timely manner to support member or provider satisfaction.
- Build and strengthen relationships with members or providers by providing quality customer service.
- Maintain knowledge and understanding of processes and procedures.
- Follow departmental and company policies and procedures.
- Maintain complete and accurate documentation of telephone and written communications.
- Act as a mentor to new hire employees.
- Perform other job-related instructions as requested.
Benefits
- May qualify for a bonus tied to company and individual performance.
- Substantial and comprehensive total rewards package.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
