Customer Care Specialist I
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Job Description
Customer Care Specialist handling Ohio members’ and providers’ routine healthcare service inquiries for CareSource. Resolving claims, benefits, eligibility, credentialing, and transportation requests remotely.
Responsibilities:
- Resolve member/beneficiaries or provider routine service inquiries, including claims processing, member benefit education, contracting and credentialing requests, eligibility inquiries, and transportation arrangements when applicable
- Ensure all HIPAA, State and/or Federal requirements/regulations are always adhered to
- Research, follow up, and resolve all open/pending issues in a timely manner
- Build and strengthen member or provider relationships by providing quality customer service
- Maintain knowledge and understanding of all processes and procedures
- Adhere to departmental and company policies and procedures
- Maintain complete and accurate documentation of telephone and written communications
- Act as a mentor to new hire employees
- Perform other job-related instructions as requested
Requirements:
- High School Diploma or equivalent is required
- Two (2) years customer service experience is preferred
- Customer Service experience in a call center is preferred
- Critical thinking and listening skills
- Decision making and problem-solving skills
- Computer proficiency with knowledge and experience in a Windows environment
- Typing speed of 35 words per minute (WPM)
- Strong written and communication skills
- Professional phone etiquette
- Proper use of grammar
- Ability to work in a fast-paced environment
- Adaptable to a constantly changing environment
- Attention to detail
- Ability to multitask
- Ability to work independently and with a team
- Must adhere to an assigned daily work schedule and have predictable and reliable attendance
- Must adhere to all HIPAA, State and/or Federal requirements/regulations
- Licensure and Certification: None
Benefits:
- Potential bonus tied to company and individual performance
- Comprehensive total rewards package
- Employee total well-being support
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