Customer Care Specialist I – Healthcare, Medicare Experience

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

📋 Description

• Address routine inquiries from members, beneficiaries, or providers regarding services, including claims processing, member benefit education, contracting and credentialing requests, eligibility questions, and transportation arrangements when necessary.

• Ensure adherence to HIPAA and state and federal regulations and requirements.

• Investigate, follow up on, and resolve outstanding or pending issues promptly.

• Develop and enhance relationships with members or providers through high-quality customer service.

• Stay informed about processes and procedures.

• Comply with departmental and corporate policies and procedures.

• Keep thorough and accurate records of both telephone and written communications.

• Provide mentorship to new employees.

• Execute other job-related tasks as directed.

⛳️ Requirements

• Residency in Ohio is required.

• A High School Diploma or equivalent is mandatory.

• A minimum of two (2) years of customer service experience is preferred.

• Experience in a call center environment is preferred.

• Strong critical thinking and listening abilities.

• Proficient in decision-making and problem-solving.

• Computer skills with familiarity and experience in a Windows environment.

• A typing speed of at least 35 words per minute (WPM).

• Excellent written and verbal communication skills.

• Professional phone manners.

• Correct use of grammar.

• Capability to thrive in a fast-paced setting.

• Flexibility to adapt to an ever-changing environment.

• Keen attention to detail.

• Ability to handle multiple tasks simultaneously.

• Capacity to work independently as well as collaboratively within a team.

• Must maintain a reliable daily work schedule and demonstrate predictable attendance.

• No specific licensure or certification is necessary.

🏝️ Benefits

• Opportunity for bonuses based on company and individual performance.

• Extensive and comprehensive total rewards package.

• Support for overall employee well-being.