Customer Experience Specialist

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

📋 Description

• Establish meaningful connections with each member by consistently demonstrating empathy, patience, and respect, ensuring they feel acknowledged, supported, and valued throughout all interactions.

• Take full ownership of each member interaction, being accountable for resolving inquiries during the initial contact and ensuring clear follow-up when additional actions are necessary.

• Provide outstanding service by continually surpassing member expectations and fostering a culture centered on 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, benefits concerning transportation, food, dental, and other support services, while proactively identifying solutions and next steps.

• Handle incoming contacts within established service levels, managing complex and sensitive situations with professionalism and care.

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

• Proactively resolve member complaints, grievances, and disenrollment issues by identifying root causes, offering solutions, and escalating matters appropriately when necessary.

• Support outbound outreach initiatives and service programs aimed at enhancing engagement, education, and the overall member experience.

⛳️ Requirements

• A minimum of 2 years of customer service, contact center, or member support experience, ideally in the healthcare and/or Medicare Advantage sector.

• High school diploma or GED is required.

• Minimum typing speed of 40 WPM.

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

• On-camera presence required for 100% remote training, one-on-one meetings, team, and group sessions.

• Clear, concise, and warm verbal communication skills, capable of explaining complex information simply and compassionately, along with the ability to document interactions accurately.

• Proven empathy, patience, and respect when interacting with older adults and individuals with disabilities.

🏝️ Benefits

• Health insurance

• Professional development opportunities