Client Service Support Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Act as the primary point of contact for clients seeking assistance with support services, appeals, grievances, social service requirements, billing inquiries, and insurance coverage issues.

• Actively engage with clients, addressing their concerns with empathy and providing accurate, prompt solutions through various communication channels (phone, chat, email).

• Assist clients in navigating complex matters, including the submission and tracking of appeals and grievances.

• Address billing discrepancies and clarify insurance coverage details.

• Provide referrals related to Social Determinants of Health (SDOH) within the community.

• Manage escalations and handle compliance-sensitive issues effectively.

• Facilitate warm transitions to internal specialists or external partners when further expertise or intervention is required.

• Accurately document all client interactions in the CRM system to ensure continuity of care and adherence to policies.

• Identify urgent or high-risk situations and escalate them appropriately according to established protocols.

• Keep current on service offerings and relevant regulations.

• Collaborate with various internal departments.

• Engage in quality improvement initiatives, team meetings, and feedback sessions to enhance the client experience.

⛳️ Requirements

• A Bachelor's degree is mandatory.

• At least 3 years of customer service experience in a healthcare contact center environment is required.

• Preference for candidates with experience in a virtual contact center and digital navigation.

• Proven dedication to serving diverse populations with empathy, humility, and respect for cultural differences.

• Excellent verbal and written communication skills, with the ability to convey complex information compassionately and clearly.

• Knowledge of billing procedures, insurance plans, appeals, and grievance resolution processes.

• Understanding of Social Determinants of Health (SDOH) and the ability to direct clients to suitable resources.

• Capability to maintain composure and professionalism under pressure, particularly when dealing with escalated issues.

• Demonstrated problem-solving abilities and resourcefulness in addressing client needs.

• Experience handling HIPAA-regulated data and ensuring client confidentiality.

• Proficient with CRM systems, ticketing platforms, and digital communication tools.

• Strong organizational skills with a keen attention to detail and follow-through.

• Ability to learn new processes and adapt to changes quickly.

• Team-oriented, flexible, and motivated by a mission-driven, fast-paced environment.

• Proactive in identifying problems and proposing solutions.

• Outstanding problem-solving and time management skills.

🏝️ Benefits

• Health insurance

• Paid time off

• Flexible work arrangements

• Professional development opportunities