Customer Experience Specialist

This is a fully remote position, open to applicants in California, +1 more state.

📋 Description

• Establish meaningful connections with each member by consistently demonstrating empathy, patience, and respect, ensuring they feel acknowledged, supported, and valued in every interaction.

• Take ownership of each member's experience from start to finish, being accountable for resolving inquiries on the first contact while ensuring clear follow-up for any necessary additional steps.

• Provide outstanding service by consistently surpassing member expectations and fostering a culture centered around trust, compassion, and first-call resolution.

• Respond accurately to member inquiries regarding benefits, eligibility, services, policies, and procedures in a clear, confident, and member-friendly manner.

• Assist members with inquiries related to provider networks, claims/reimbursements, and benefits concerning transportation, food, dental, and other support services, proactively identifying solutions and next steps.

• Manage incoming contacts within established service levels while professionally handling complex and sensitive situations with care.

• Document all member interactions, actions taken, and outcomes in real-time to ensure accuracy, continuity of care, and effective resolution.

• Address member complaints, grievances, and disenrollment issues proactively, aiming to resolve them by identifying root causes, proposing solutions, and escalating when necessary.

⛳️ Requirements

• 2+ years of experience in customer service, contact centers, or member support, ideally within healthcare and/or Medicare Advantage.

• A high school diploma or GED is required.

• A college degree, whether an Associate’s or Bachelor’s, is preferred, or an equivalent combination of education and work experience.

• Minimum typing speed of 40 WPM.

• Proficient in using multiple systems simultaneously, including Microsoft Outlook, Word, Excel, CRM, and Contact Center solutions.

• Excellent verbal communication skills, characterized by clarity, warmth, and the ability to simplify complex information with compassion.

• Proven ability to demonstrate empathy, patience, and respect when engaging with older adults and individuals with disabilities.

• Comfortable working within a culture of continuous coaching, feedback, and performance improvement to meet defined KPIs related to attendance, schedule adherence, and quality.

🏝️ Benefits

• Health insurance

• 401(k) matching

• Paid time off

• Flexible work arrangements

• Professional development opportunities