Member & Provider Care Specialist

This is a fully remote position, open to applicants in Arizona, +2 more states.

📋 Description

• Resolve intricate issues or concerns affecting providers and their members.

• Act as a subject matter expert for Member and Provider Services.

• Facilitate communication between production teams and optimization/strategy teams.

• Provide assistance with internal inquiries and training support.

• Engage with members and providers effectively.

• Contribute to the tracking and reporting of network-related issues.

• Aid in enhancing the knowledge management system.

• Ensure that workflows are thorough and current.

• Oversee a queue of assigned cases.

• Manage inbound and outbound calls, secure messages, and/or email communications.

• Supervise queue tasks and assigned caseload through dashboard management.

• Identify, investigate, and resolve issues within specified SLAs.

• Collaborate with colleagues, Experts, and Leads to pinpoint trends and obstacles.

• Utilize internal tools and resources effectively.

• Convey findings and resolutions to providers and internal departments.

• Assist Member and Provider Services Representatives with intricate issues, workflows, and training.

• Elevate updates or inaccuracies in the internal knowledge management system.

• Partner with production teams across LifeCycles to enhance the experience for both members and providers.

• Adhere to all applicable laws and regulations.

• Carry out other duties as assigned.

⛳️ Requirements

• A minimum of 1 year in customer support, healthcare, technology, or a related field.

• Experience in a dynamic, fast-paced environment.

• At least 6 months of member and customer service experience.

• Over 1 year of experience handling escalations in a customer service setting.

• More than 1 year of claims experience (preferred).

• Bilingual in Spanish (preferred).

🏝️ Benefits

• Comprehensive employee benefits.

• Monthly vacation accrual at a rate of 15 days per year.

• Medical insurance coverage.

• Dental insurance coverage.

• Vision insurance coverage.

• 11 paid holidays annually.

• Paid sick leave.

• Paid parental leave.

• Participation in a 401(k) plan.

• Life insurance coverage.

• Disability insurance coverage.

• Paid wellness time and reimbursements.