Florida Blue

Member Care Specialist
United States, Remote

Customer Service

Member Care Specialist-Remote

**Teacher like schedule-3 months paid time off**

Start date: September 9th

Leave Dates: June 13th- September 13th

Location: Work from Home

Job Summary

Are you looking to build a career that is truly helping people and not just processing widgets? Are you passionate about providing world class customer satisfaction? Are you an awesome team player and love to serve others? Do you like solving problems? If so, we have a job for you! 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 and will be responsible for representing the values of ‘customer first’ to our members.This position gives you the opportunity to work from home and take 3 months of paid time off as well as our Florida Blue Benefits.

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)
  • Ability to resolve/respond to customer inquiries and concerns, using sound problem solving, critical thinking and decision-making skills
  • Demonstrated empathy and compassion, with outstanding listening and excellent communication skills
  • Ability to work assigned shift including seasonal peaks of nights, weekends, holidays as business needs require, in a production environment answering questions and resolving simple to complex issues
  • Complete an extensive virtual training program including demonstration of learnings.

Work from home requirements:

  • Employees are responsible for providing a computer that meets technical requirements of the job. The minimum operating systems on home equipment is Windows XP or higher.
  • Employees are responsible for obtaining and paying for high-speed internet services.
  • Must have adequate phone service.
  • A landline is preferable over a cell phone.
  • If employee utilizes a cell phone and if at any time the connection is deemed as not adequate, employee may be required to obtain a land line at employee’s expense.
  • High school diploma or equivalent
  • Employees must have adequate office space that is conducive to performing work. Isn’t it required to be a locked space?
  • Any other system requirements are the employee’s responsibility.
  • Employee is expected to work the same number of hours as if he/she were on-site at Florida Blue. Management must approve in advance any deviations from the regular work schedule.

Preferred Criteria

  • Previous experience working with a health insurance company
  • Bilingual- Spanish or Creole

Additional Information
Job Type: Graduate Job
Schedule: Full-Time