Customer Care Associate

Job Description

REQUIREMENTS

• Experienced in Service: You have at least one year of customer service experience, preferably in a healthcare setting.
• Strong Communicator: You explain complex information clearly and maintain professionalism on every call.
• Organized & Reliable: You can manage multiple member requests while maintaining attention to detail.
• Comfortable with Systems: Proficient in Microsoft Word, Excel, and call documentation tools.
• Adaptable & Willing to Learn: Open to training and building expertise in healthcare plans, systems, and regulations.

RESPONSIBILITIES

• Provide Direct Support: Handle incoming calls, explain healthcare benefits, services, and provider options clearly.
• Resolve Member Issues: Identify needs, research information, and determine appropriate next steps or referrals.
• Coordinate Follow-Up: Make outbound calls as needed to complete research or deliver updates.
• Maintain Accurate Records: Collect and update member demographic data in the system.
• Ensure Compliance: Follow company procedures and healthcare regulations, including HIPAA and COBRA guidelines.
• Collaborate Across Teams: Transfer inquiries to the appropriate internal/external contacts when needed.

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