Customer Engagement Specialist

Job not on LinkedIn

🔥 1 minute ago

🤠 Texas – Remote

🤠 Texas – Remote

💵 $19 - $22 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🏆 Customer Success

🚫👨‍🎓 No degree required

Apply Now

Find Similar Remote Jobs

Receive Emails For Remote Jobs

📊 Check your resume score for this job

Improve your chances of getting an interview by checking your resume score before you apply.

Upload Resume

Guide Healthcare

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

🎯 Recruiter

Healthcare Insurance • Healthcare • Recruitment

Guide Healthcare is leading a movement where creativity delivers positive change in the healthcare sector. The company specializes in allied health service provision and healthcare recruitment, focusing on the support and treatment of older adults. With a commitment to adding value to their clients, partners, and teams, Guide Healthcare aims to do things differently in the industry.

📋 Description

• Provide friendly, accurate, and timely service to Customers (members/patients, providers, and other stakeholders) through inbound and outbound interactions via phone, email, chat, SMS, video calls, co-browser sessions, and other communication channels. • Actively listen to understand Customers’ needs and concerns and demonstrate empathy and patience. • Help Customers navigate internal processes and available resources to achieve their desired results. • Build rapport and establish trust with Customers to create a positive, personalized experience. • Go above and beyond to exceed Customer expectations and leave a lasting positive impression. • Protect Customers’ privacy, dignity, and Personal Health Information (PHI) at all times and comply with HIPAA and all applicable laws and regulations. • Backup and support other departments (i.e., Claims, UM, Intake, Quality, Care Management, Patient Engagement) and perform a variety of other duties as assigned. • Issue Resolution and Problem Solving: Answer inquiries regarding benefits, claims, eligibility, provider networks, prior authorizations, preventative health promotion, and other healthcare-related topics. Research and resolve complex issues, collaborating with other departments as needed (e.g., Claims, Provider Relations, Utilization Management, Intake, Care Management, Quality, etc.). Take ownership of Customer issues, following through to ensure complete resolution and satisfaction. Proactively identify and escalate recurring issues or trends to management. Document all interactions and resolutions accurately and thoroughly in the appropriate systems. • Research and solve Customer issues and reply to Customer inquiries with friendly, accurate, and timely resolutions. • Healthcare Consumer Education: Educate Customers on plan benefits, policies, and procedures. Clearly and concisely explain complex healthcare information in a way that is easy to understand. Encourage the use of our self-service portal and effectively teach Customers how to navigate and use our portal and other available resources. Empower Customers with the knowledge they need to make informed decisions about their health and benefits. • Outbound Outreach and Program Enrollment: Conduct outbound enrollment outreach, inviting eligible members/patients to join Guidehealth’s care management and care coordination programs. Conduct outbound clinical quality and wellness outreach, including medication refill reminders, blood pressure check-ins, preventive care reminders, gap-in-care closure, and general wellness check-ins. Handle inbound calls from prospective enrollees inquiring about Guidehealth’s care management programs, qualifying interest and guiding them through next steps. Clearly articulate the value, features, and benefits of our programs in plain, customer-centered language, helping Customers understand how participation supports their health goals. Apply consultative listening and persuasion skills to address hesitation, answer questions, and overcome common objections with empathy, patience, and respect for the Customer’s decision. Follow approved scripts, talking points, and call flows while adapting tone and pacing to each individual member. Operate effectively within dialer-based outbound workflows, manage call dispositions accurately, and meet outreach productivity and quality targets. Recognize and appropriately escalate clinical and behavioral health concerns, as well as urgent member needs, identified during Customer interactions. Comply with all applicable outbound calling regulations and policies, including TCPA, state do-not-call rules, and Guidehealth scripting and disclosure standards. (Note: Customer Guides do not close sales transactions or collect payments; the focus is enrollment, education, and customer engagement.) • Compliance and Quality: Actively seek and accept coaching, feedback, and opportunities for professional development from peers, Customer Guide Coaches, Trainers, and Managers. Adhere to all company policies, procedures, and regulatory requirements (e.g., HIPAA). Maintain confidentiality and protect sensitive member information. Meet or exceed individual and team performance goals related to Customer satisfaction (CSAT), first contact resolution, quality, efficiency, attendance, and schedule adherence. Participate in ongoing training and development to enhance skills and knowledge. Contribute thoughtful ideas and suggestions for improvement and promote a positive and collaborative team environment.

🎯 Requirements

• High school diploma or equivalent required. • Minimum of 2 years of experience in one or more of the following: customer service in a health plan, HMO, TPA, or healthcare setting; OR program enrollment, telemarketing, cold calling, appointment setting, inside sales, or other outbound calling roles. • Candidates with experience in both inbound and outbound Customer service via multiple channels are strongly preferred. • Minimum of 1 year of experience in a healthcare contact center or outbound calling environment. • Exceptional, demonstrated customer service skills, with a genuine passion for helping others. • Strong empathy, patience, and the ability to build rapport with diverse individuals. • Excellent verbal and written communication skills, excellent grammar, and pronunciation in the English language. • Ability to communicate clearly, concisely, and professionally. • Active listening skills and the ability to understand and address customer needs effectively. • Strong persuasion and objection-handling skills, with the ability to articulate the value of programs and services in a clear, Customer-centered way (note: this role does not involve closing sales transactions or collecting payment). • Comfort with structured outbound calling, scripted call flows, and dialer-based workflows. • Resilience and a positive, professional attitude when navigating refusals, voicemails, unanswered calls, and repetitive dialing volume. • Strong problem-solving and critical-thinking abilities. • Ability to navigate complex systems and processes. • Proficiency with computer systems, including CRM software and Microsoft Office Suite. • Ability to learn and retain information quickly. • Ability to work independently and as part of a team; must possess a high level of accountability for your work and in support of the team and the business. • Ability to handle stressful situations with professionalism and composure. • Knowledge of medical terminology, healthcare benefits, and insurance processes.

🏖️ Benefits

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs. • Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered. • Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution. • Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected. • Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times. • Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals. • Support Your New Family: Guidehealth offers paid parental leave to give you the time you need. • Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.