Member Care Specialist

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Hialeah, FL

Job status
Full time
Job description
Meet with our recruiters on Wednesday June 12th between 10AM and 2PM.

Job Summary
As a Member Care Specialist in our Doral Florida office, you will play a key role within the organization! You will interface with with both new and existing customers consisting of individual members, group members, business decision makers and agents. You will work across many systems and multiple business areas to resolve service inquiries, process transactions and adjudicate claims.
Education requirements
· High school diploma or equivalent
Experience requirements
· 2 years customer service experience (retail, face to face, phone, chat) with work involving financial, accounting and/or claims processing

· 1 year experience involving collaboration and relationship building with external partners, such as sales agents, brokers, consultants, key accounts, providers and vendors

· Previous experience working with a health insurance company (preferred)

· Ability to work assigned shift and or nights, weekends, holidays as business needs require
· Review a member’s enrollment or claims history including all debits and credits and claims detail level at the member level for a multi-year period ensuring accuracy of billing and enrollment and application of deductible and member responsibility.

· Utilize the Florida Blue Call Strategy to provide outstanding customer service and call resolution to our members; follow-up on issues to ensure resolution for customer.

· Evaluate data through questioning, probing, and reasoning for process improvements.

· Research and resolve sales and service related inquiries for all lines of business, health and ancillary products, meeting established expectations for quality, productivity and timeliness.
· Ability to resolve/respond to customer inquiries and concerns, using sound problem solving and decision making skills.

· Demonstrated empathy and compassion, with excellent listening and communication skills.

Apply Today and plan to meet with our recruiters on Wednesday June 12th between 10AM and 2PM. (address will be send to your email)