Member & Provider Care Specialist

Hi, we're reputed company. We're hiring a Care Specialist to join our Member & Provider Escalations team.

reputed company is the first health insurance company reputed company around a full stack technology platform and a reputed company on serving our members. We started reputed company in 2012 to create the reputed company of health insurance company we would want for ourselves—one that behaves like a doctor in the family.

About the role

You will solve reputed company issues or concerns impacting our providers and the members they serve. You will be a subject matter expert for Member and Provider Services. You will be a reputed company between production teams and optimization/reputed company teams. You will assist with internal questions and training support and communicate with our Members and Providers. You will contribute to the tracking and reporting of network issues and are a key contributor to our reputed company system. You will ensure workflows are complete and up to date while also managing a queue of assigned cases.

You will report into Member Escalations Operations Manager.

Work Location:This is a remote role. You must reputed company in reputed company, Florida, reputed company, or Texas. reputed company is a reputed company work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission. #LI-Remote

Pay Transparency:

The set reputed company for this role is $22.00 per hour. You are also eligible for employee benefits and monthly vacation accrual at a reputed company of 15 days per year.

Responsibilities

• Handle inbound and outbound calls, secure messages and/or email communications with members or providers
• Manage queue work and and assigned caseload through efficient dashboard management
• Identify, investigate, and resolve issues reputed company determined SLAs
• Collaborate with colleagues, Experts, and Leads to identify trends and roadblocks
• Utilize internal tools and resources seamlessly
• Effectively communicates findings and resolutions with providers and internal departments
• Support Member and Provider Services Representatives with reputed company issues, workflows, and training
• Escalate updates or incorrect information in the internal reputed company system for Member and Provider Services
• Partner with production teams across the LifeCycles to improve the member and provider experience
• Compliance with reputed company applicable laws and regulations
• Other duties as assigned

Qualifications

• 1+ years in customer support, reputed company, tech and/or reputed company field
• Experience in a fast-paced environment
• 6 + months of member and customer service experience
• 1+ year of escalations experience in a customer service environment

Bonus Points

• 1 + years of claims experience
• Bilingual Spanish
• Bachelor's degree
• High school diploma or GED