Healthcare Customer Service Specialist

  • location: Tampa, FL
  • type: Contract
  • salary: $16.44 per hour
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job description

Healthcare Customer Service Specialist

job summary:
JOB SUMMARY

Detail oriented Grievence Coordinator with healthcare customer service experience needed to respond to member and provider inquiries (phone written or walk in) regarding all aspects of Company business including claims in a professional timely accurate and caring manner while consistently meeting all guidelines

ESSENTIAL FUNCTIONS Note: The following is not intended to be an exhaustive list of all duties required of this position

Key Duties and Responsibilities

  • Responds to member provider and other inquiries via telephone correspondence or lobby walk-in while meeting all corporate guidelines and performance standards
  • Demonstrates appropriate customer-care skills such as empathy active listening courtesy politeness helpfulness and other skills as identified
  • Records investigates and resolves member complaints as detailed in the Grievance Procedure narrative
  • Assists in the education of new members and in the re-education of existing members regarding health plan procedures
  • Track grievance case by line of business for compliance and review
  • Assist in resolving member and provider complaints
  • Makes decisions that are consistent with the concept of a win-win-win for members associates and Company
  • Demonstrates based behaviors such as initiative accountability and value
  • Performs skills necessary to create a high-quality customer experience as reflected through acceptable quality audit score and productivity
Requirements:

  • A High School or GED Required
  • An Associate's Degree in a related field Preferred or equivalent work experience
  • 1+ year of experience in a call center or customer service environment Required
  • 1+ year of experience in grievance experience Preferred
Skills:

  • Demonstrated written communication skills Intermediate
  • Demonstrated interpersonal/verbal communication skills Intermediate
  • Ability to multi-task Ability to multi-task good organizational and time management skills Intermediate
  • Demonstrated organizational skills Intermediate
  • Ability to effectively present information and respond to questions from families members and providers Intermediate
 
location: Tampa, Florida
job type: Contract
work hours: 8 to 5
education: High School
experience: 1 Years
 
responsibilities:
Key Duties and Responsibilities

  • Responds to member provider and other inquiries via telephone correspondence or lobby walk-in while meeting all corporate guidelines and performance standards
  • Demonstrates appropriate customer-care skills such as empathy active listening courtesy politeness helpfulness and other skills as identified
  • Records investigates and resolves member complaints as detailed in the Grievance Procedure narrative
  • Assists in the education of new members and in the re-education of existing members regarding health plan procedures
  • Track grievance case by line of business for compliance and review
  • Assist in resolving member and provider complaints
  • Makes decisions that are consistent with the concept of a win-win-win for members associates and Company
  • Demonstrates based behaviors such as initiative accountability and value
  • Performs skills necessary to create a high-quality customer experience as reflected through acceptable quality audit score and productivity
  • Peforms other duties as assigned
 
qualifications:
Requirements

  • A High School or GED Required
  • An Associate's Degree in a related field Preferred or equivalent work experience
  • 1+ year of experience in a call center or customer service environment Required
  • 1+ year of experience in grievance experience Preferred
Technology

  • Microsoft Outlook Knowledge of email systems such as Microsoft Outlook sufficient to communicate with both internal and external contacts Beginner Required
  • Microsoft Excel Beginner Required
  • Microsoft Word Beginner Required
  • Healthcare Management Systems (Generic) Beginner Required
 
skills: Other
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.

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