Customer Service Specialist - Liberty Advantage

Liberty Healthcare Management Wilmington, North Carolina, United States

Liberty Cares
With Compassion

Liberty Advantage is currently seeking an experienced:

CUSTOMER SERVICE SPECIALIST

Full Time

Job Summary:

• Handle escalated calls from members/providers or vendors resolving issues, preferably the first time.
• Help educate members on the benefits that are available to them, whether this is resolving claim information, setting up enhanced benefits….
• Intervene with care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialist for assistance when needed
• Assist with enrollment team to set up new members
• Document and resolve any Appeals and Grievances within required time frames as set by CMS
• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or collaborate with others to resolve escalated issues.
• Set-up and triage prior authorization requests, working through clinical protocols.

Job Requirements:

• Minimum of 3+ years of combined education, work and/or volunteer experience
• Excellent listening, verbal, written and interpersonal communication skills.
• High level of professionalism and confidentiality, with a strong customer service focus.
• Can adapt well to operational needs with excellent follow-up skills.
• Must be self-motivated, with a work ethic of dedication and the discipline to work independently.
• Must have a valid driver's license.
• Proven ability to communicate concisely and confidently with all staff levels. Can clearly communicate instructions to remote users.