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Member Care Specialist (Lake Mary)

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Customer Service
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Member Care Specialist
 
**Teacher like schedule-3 months paid time off**
 
Likely start date July 15, 2019
 
Leave dates between May 2020-July 2020
 
Location (Orlando) Lake Mary, Florida
 
Job Summary
The Member Care Specialist is a key role within the organization that will serve potential, new and existing customers which include individual members, group members, business decision makers and agents.  This role will work across many systems and multiple business areas to resolve service inquiries, process transactions and adjudicate claims.
 
Essential Job Functions
·       Review a member’s enrollment or claims history including all debits and credits and claims detail level at the member level for a multi-year period ensuring accuracy of billing and enrollment and application of deductible and member responsibility.
·       Utilize the Florida Blue Call Strategy to provide outstanding customer service and call resolution to our members; follow-up on issues to ensure resolution for customer.
·       Evaluate data through questioning, probing, and reasoning for process improvements.
·       Research and resolve sales and service related inquiries for all lines of business, health and ancillary products, meeting established expectations for quality, productivity and timeliness.
 
Minimum Job Requirements
·       2 years including customer service experience (retail, face to face, phone, chat, experience with financial reconciliation and accounting activities and/or claims processing)
·       1 year of collaboration relationship building with external partners, such as sales agents, brokers, consultants, key accounts, providers and vendors
·       Ability to resolve/respond to customer inquiries and concerns, using sound problem solving and decision making skills
·       Demonstrated empathy and compassion, with outstanding listening and communication skills
·       Ability to work assigned shift and or nights, weekends, holidays as business needs require , in a production environment  answering questions  and resolving simple to complex issues
·       High school diploma or equivalent
 
Preferred Criteria
·       Previous experience working with a health insurance company

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