Customer Service Specialist

A company is looking for a Customer Service Specialist to support customer inquiries and enhance service delivery.

Key Responsibilities

Address complex customer inquiries through various communication channels while ensuring confidentiality and professionalism

Champion customer-centricity by actively listening to member concerns and advocating for solutions

Support health management functions by collecting participant information, scheduling appointments, and conducting outbound calls

Required Qualifications

High School diploma or GED with five to seven years of experience in a healthcare customer service call center

Strong knowledge of health claims processing and understanding of benefit contracts and policies

Ability to interpret Plan Documents and understand regulatory requirements such as ACA, HIPAA, ERISA, and COBRA

Fluent in English; bilingual in Spanish preferred

Proficient in learning new software and navigating multiple systems simultaneously