Customer Care Resolution Specialist

🔥 0 minutes ago

🏈 Ohio – Remote

🏈 Ohio – Remote

💵 $47.4k - $76k / year

⏰ Full Time

🟢 Junior

💝 Customer Support

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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CareSource

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 30+ years

🏥 Healthcare

🛡️ Insurance

⚕️ Healthcare Insurance

Healthcare • Insurance • Healthcare Insurance

CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.

📋 Description

• Serve as a subject matter expert while staffing the assist line and responding accurately to inquiries from Customer Care Specialists • Handle and resolve escalated calls from members and providers • Act as a New Hire Transition Coach for new employees • Identify process gaps and partner with the Business Integration Team to resolve them • Provide peer-to-peer feedback and identify training needs for Customer Care Specialists • Manage and process incoming work from route boxes, faxes, email, web inquiries, and ServiceNow queues • Partner with other departments to achieve internal service levels • Maintain SME status through self-education and procedural updates • Document second-level support questions in the Assist Line Tracking Database • Assist members and providers with routine service inquiries • Research, follow up on, and resolve open or pending issues • Create and conduct departmental training as business needs require after completing CareSource University Functional Facilitator certification • Perform other duties as requested

🎯 Requirements

• High School education or equivalent required • Minimum of one (1) year experience in Customer Care (Member Services or Provider Services) required • Minimum of three (3) years customer service experience in a call center preferred • Minimum of two (2) years of HMO or related industry experience preferred • Strong understanding of Customer Care processes • Ability to deescalate difficult conversations • Ability to determine root cause of problems and propose solutions • Computer proficiency with knowledge and experience in a Windows environment • Typing speed of 35 WPM • Claims and Coding Experience (ICD9, CPT4, HCPCS, Revenue Code and Dental Coding) • Excellent 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 • Critical thinking and listening skills • Decision making and problem solving skills • Ability to coach and provide feedback effectively • Understanding of Medicaid • Must adhere to an assigned daily work schedule and have predictable and reliable attendance • Must adhere to all HIPAA and State requirements/regulations

🏖️ Benefits

• Bonus tied to company and individual performance may be available • Substantial and comprehensive total rewards package • Employee total well-being support