Customer Service Specialist

This is a fully remote position, open to applicants in Alabama, +15 more states.

📋 Description

• Establish and nurture trusted relationships with clients, claimants, and pharmacies by delivering exceptional customer service to every caller.

• Address phone inquiries concerning claims adjudication, eligibility verification, prior authorization, Pharmacy Benefit Management, Ancillary Benefits Management, and various functions of the Billing Verification Department.

• Collaborate with the Team Lead, Supervisor, and Manager to resolve customer inquiries effectively.

• Utilize verbal and written communication, along with listening, organizational, problem-solving, and reasoning skills.

• Comply with attendance, punctuality, and quality standards.

• Simplify jargon and complex processes into clear, step-by-step instructions.

• Manage challenging customers and situations with meticulous attention to detail, patience, professionalism, and empathy.

• Tailor communication approaches to accommodate diverse member styles and personalities.

• Take initiative and accept responsibility when appropriate.

⛳️ Requirements

• A high school diploma or general education degree (GED) along with one to two years of relevant customer service and/or healthcare experience is required; or an equivalent combination of education and experience.

• Access to reliable, high-speed internet with adequate bandwidth.

• A private workspace that is free from distractions and noise.

• Proficiency in Windows-based applications.

• Capability to multitask using dual monitors.

• Ability to quickly enter information via keyboard.

• Skill in reading prescription drug names.

• Competence in understanding simple instructions.

• Ability to compose brief correspondence/memos.

• Prior experience in an administrative business environment is highly preferred.

• Experience in the healthcare industry is preferred.

• Flexibility to work varying or rotating shifts, including overtime, weekends, and holidays as needed.

🏝️ Benefits

• Work-From-Home model.

• Healthcare coverage.

• PTO.

• Paid holidays.

• 401(k).

• Company-provided life insurance/disability coverage.

• Wellness options/resources.

• Company laptop provided.

• Recognition programs.

• Dental insurance.

• Vision insurance.

• Statutory benefits, including Colorado HFWA.

• Travel may be required to attend meetings and visit locations throughout the country.