Job Summary:

The Customer Care Specialist I assists members/beneficiaries or providers with routine service inquiries.

Essential Functions:

• Resolve member/beneficiaries or provider routine service inquiries; examples include claims processing, member benefit education, contracting and credentialing requests, and when applicable, eligibility inquiries, and transportation arrangements.
• Ensure all HIPAA, State and/or Federal requirements/regulations are always adhered to.
• Research, follow up, and resolve all open/pending issues in a timely manner to ensure member or provider satisfaction.
• Build and strengthen member or provider relationships by providing quality customer service.
• Maintain knowledge and understanding of all processes and procedures.
• Adhere to all departmental and company policies and procedures.
• Maintain complete and accurate documentation of all of telephone and written communications.
• Act as a mentor to new hire employees.
• Perform any other job related instructions, as requested.

Education and Experience:

High School Diploma or equivalent is required. Two (2) years customer service experience is preferred. Customer Service experience in a call center is preferred.

Competencies, Knowledge and Skills:

• Critical thinking and listening skills.
• Decision making and problem-solving skills.
• Computer proficiency with knowledge and experience in a Windows environment.
• Typing speed of 35 words per minute (WPM).
• Strong written and communication skills.
• Works well under pressure.
• 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.

Licensure and Certification:

None.

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time. Must adhere to an assigned daily work schedule and have predictable and reliable attendance.

Compensation Range:

$35,900.00 - $57,300.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Hourly

Organization Level Competencies:

• Fostering a Collaborative Workplace Culture.
• Cultivate Partnerships.
• Develop Self and Others.
• Drive Execution.
• Influence Others.
• Pursue Personal Excellence.
• Understand the Business.

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

#LI-KM1