Customer Engagement Specialist

Job Overview

JOB DETAILS

REQUIREMENTS

• High School Diploma or equivalent required.
• 2+ years of experience in a healthcare customer service role.
• 1+ year of experience in a high-volume call center.
• Ability to work 40 hours/week, Monday – Friday, with availability between 7:00 a.m. and 8:00 p.m. Central Time is required.
• Proficient computer skills including Microsoft Word, Excel, Outlook required.
• Capacity to work unencumbered and independently in a home office/virtual environment.
• Internet connection must be through a cable broadband or fiber optic internet service provider with speeds of at least 50 Mbps download/25 Mbps upload required. *No mobile hot spots permitted.
• Proficiency to navigate multiple computer software/systems and multi-screen functionality with ease.
• Demonstrated sensitivity, empathy, and compassion with Member callers.
• Able to maintain confidentiality and adhere to HIPAA requirements.
• Excellent written communication: ability to document caller interactions in a concise manner.
• Active listening skills while providing exceptional customer service.
• Excellent verbal communication skills with the ability to present information in an empathetic, clear, way. Must be adaptable, flexible, and readily able to adjust to changing situations.
• Able to apply logical thinking when evaluating problems.
• Adept to interacting with diverse populations.
• Overtime may be required at times during peak seasons.
• Associate’s Degree in Business, Management, or Operations.
• 2+ years of experience in dental insurance or a dental office.
• Exposure to Medicare, Medicare Advantage, or Medicaid insurance claims.
• Fluency in Spanish highly desired.

RESPONSIBILITIES

• Answer 40-60 inbound calls, responding to inquiries ranging from routine to moderate complexity.
• Capture member information accurately and update systems with complete and concise data.
• Ensure flexibility, stay organized, and comply with constantly changing programs and business rules.
• Investigate issues that cannot be resolved at the time of initial call. Collaborate with internal teams to research and follow up with the Member until a resolution occurs.
• Comfortable working in the healthcare field, with an acute awareness for privacy, confidentiality, HIPAA requirements and professionalism.
• Ability to determine proper issue escalation – joining forces with other internal departments for answers, therefore closing the loop and providing a solution for the Member.

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