Health Plan Specialist - Commercial

We are looking for a customer-focused Health Plan Specialist to support member inquiries. In this role, you will respond to inbound calls from individuals seeking guidance on benefits, billing, and enrollment, while delivering clear, accurate, and compassionate service. This position is ideal for someone who thrives in a fast-paced call center setting, can manage high call volumes during open enrollment, and takes pride in resolving issues thoroughly from start to finish.

Responsibilities:
• Handle a high volume of inbound member calls, addressing questions related to health plan benefits, premium billing, eligibility, and enrollment details.
• Take full ownership of each inquiry by researching concerns, documenting interactions carefully, and ensuring issues are resolved completely and on time.
• Use available systems, reference materials, and online resources to provide accurate information and support sound member decisions.
• Deliver respectful, attentive service in every interaction while demonstrating empathy and a strong commitment to the member experience.
• Manage complex situations with careful problem-solving, clear explanations, and appropriate follow-up when additional action is required.
• Maintain detailed and organized records to support quality standards, compliance expectations, and continuity of service.
• Participate in virtual training, team meetings, and coaching activities, including camera-on sessions in a remote work environment.
• Follow assigned scheduling requirements, including flexibility to work various shifts Monday through Friday and Saturday hours as needed during business demand.
• Support peak seasonal workloads, including open enrollment periods, by consistently meeting productivity, attendance, and service expectations.