Health Care Customer Service Advocate
About the Company: We are seeking a dedicated Healthcare Customer Service Representative to join our team. This role involves assisting members with inquiries related to their insurance plans, eligibility, benefits, and claims. The ideal candidate will have a strong understanding of various insurance plan types and excellent communication skills. About the Role: Healthcare Basics Recognize and understand various insurance plan types, including Commercial, Individual Products, HIX, and Government Plans (Medicaid/Medicare). Familiarity with common insurance terminology and procedures. Key Responsibilities: Phone Skills Receive and respond to member inquiries via inbound calls using NICE inContact - Max Agent. Make outbound calls to members, vendors, and other departments. Follow established call flow processes for member interactions. Understand and apply protocols for using the language line for effective communication.
- Eligibility and Enrollment
Verify member status, including ID numbers and personal information, using Salesforce, CSC, and QNXT. Confirm member eligibility and plan effective dates. Manage member correspondence, including sending plan documents and updating demographics. Apply Job!