Healthcare Customer Service Specialist
Job Summary
The Healthcare Customer Service Specialist serves as the primary point of contact for healthcare members. You will assist with inquiries regarding benefits, claims, and billing through phone, email, or chat. The role requires delivering exceptional service while ensuring accurate documentation and compliance with healthcare policies.
Responsibilities
- Manage inbound/outbound customer interactions
- Assist with benefits, claims, and billing inquiries
- Resolve customer concerns and follow up
- Document interactions and update member records
- Maintain HIPAA compliance
Required Skills
- Excellent communication skills
- Problem-solving and active listening
- Basic computer proficiency
- Ability to work in fast-paced environments
- Willingness to work shifting schedules
Job Details
Key Responsibilities:
- Handle inbound and outbound customer interactions in a professional and courteous manner.
- Assist members with healthcare-related inquiries, including benefits, eligibility, claims, billing, and provider services.
- Resolve customer concerns by identifying appropriate solutions and ensuring timely follow-up.
- Accurately document customer interactions and update member records in the system.
- Maintain confidentiality of member information while complying with HIPAA and company policies.
- Meet established quality, productivity, and customer satisfaction metrics.
- Collaborate with internal departments to resolve complex customer concerns.
- Stay up to date on healthcare policies, procedures, and company guidelines.
Qualifications:
- College graduate (fresh graduates are welcome to apply; no work experience required).
- High school graduate with at least 6 months of BPO or customer service-related experience.
- Excellent verbal and written communication skills.
- Strong customer service, active listening, and problem-solving abilities.
- Basic computer navigation and typing skills.
- Willing to work onsite and on a shifting schedule, including weekends and holidays if required.
- Ability to work effectively in a fast-paced environment while maintaining professionalism and attention to detail.
- Healthcare account experience is an advantage but is not required.