The role involves resolving customer inquiries regarding insurance benefits, claims, and eligibility across various communication channels. You will also be responsible for documenting interactions, educating customers on self-service tools, and ensuring accurate information is provided to resolve complex issues.
The Member Services Specialist responds to high-volume phone inquiries regarding healthcare spending accounts and provides education on claims and reimbursement. They act as a member advocate by resolving issues, managing escalated interactions, and ensuring compliance with policy requirements.
The representative will handle inbound and outbound calls to schedule non-emergency medical transportation for members. They are responsible for verifying eligibility, entering ride details accurately, and resolving transportation-related issues.
Respond to 60-80 incoming calls daily from customers and pharmacies regarding home delivery pharmacy services and benefits. Document information accurately in computer systems and perform outbound follow-up calls as needed.
Provide professional customer service by handling inbound calls regarding billing, payments, and utility service orders. Resolve customer inquiries, schedule technician appointments, and maintain accurate support tickets.
The Customer Service Agent assists members with health insurance inquiries, claims, benefits, and provider networks via phone, email, and chat. They are responsible for troubleshooting billing issues, maintaining accurate CRM records, and ensuring compliance with HIPAA regulations.
Prepare and review US federal and state tax returns while representing clients before the IRS for audits, notices, and collection matters. Develop and execute resolution strategies, including negotiating payment plans and Offer in Compromise cases to achieve the best legal outcomes for clients.
The specialist is responsible for reducing customer churn by using retention tools and tailored value propositions to save customers from canceling. Additionally, they identify upselling opportunities and maintain strict adherence to quality and compliance standards.
Handle a high volume of incoming calls to resolve health insurance policy issues, claims, and denials. Use multiple computer programs and critical thinking to advocate for members and provide appropriate solutions.
