Healthcare Customer Service Specialist

Title: Customer Service Advocate I

Location: REMOTE - PST

Duration: 6 Months Contract (Potential to extend and to convert to FTE

Target Start Date (based on successful onboarding completion): 04/14/25

Shift: Between 8:00 AM - 7:00 PM PST - Monday - Friday

• Training Schedule: 8:00 AM - 4:30 PM PST – 30 min Lunch - CAMERA ON

Day-to-day responsibilities of this role and a description of the project:

• Advocates support inbound calls in a fast-paced environment, helping callers understand their benefits. Advocates are dedicated to addressing inquiries, issues, or concerns for both members and providers. Leverages a variety of communication channels to deliver timely, accurate, and personalized support during routine calls, with an emphasis on achieving First Call Resolution (FCR).
• All Advocates are expected to mitigate and prevent complaints from being escalated to resolve in the initial contact.
• Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
• Maintains performance and quality standards based on established contact center metrics
• Provides customer service in a fast-paced contact center environment over the phone, via live chats and emails
• Documents all members or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
• Remains up-to-date and adheres to quality standards, regulations, and all other policies to ensure quality, consistency, and compliance
• Performs other duties as assigned. Complies with all policies and standards

Performance expectations/metrics for this individual and their team:

• Expected to adhere to attendance policy
• Expected to meet Key Performance Indicators (KPI) Metrics
• Average Talk Time
• Average Hold Time
• Average After-Call Work
• Scheduled Adherence
• Meet Quality Assurance Exceptions
• Adhere to State Regulatory Standards (Appeals & Grievances, Call Drivers, etc.)

Required Skills/Experience/Education:

• 2 years of RECENT Customer Service Experience. Health Care Systems: Medicare/Medicaid preferred. Must be comfortable with high-volume calls in a fast-paced environment.
• Coachable, Team player, Phone Etiquette, Active listening, Outstanding Communication Skills, Time management & organizational skills, Strong Typing Skills 40 WPM, Strong Proficiency in Microsoft Office (Word, Excel, Outlook, Teams) Zoom, and SharePoint, Multitasking- interacting and multitasking using multiple systems and programs simultaneously.
• A wired, high-speed Internet connection is required, as a dedicated work area due to HIPPA
• Proof of High School Diploma/GED or higher is REQUIRED. Must have an on-hand copy of HSD/GED/Transcript/Degree.
• Attendance is mandatory for the first 90 days

Job Type: Contract

Pay: $19.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Flexible schedule
• Health insurance
• Paid time off
• Vision insurance

Schedule:

• Monday to Friday

Experience:

• Call center: 2 years (Required)

Location:

• Tigard, OR 97223 (Required)

Ability to Commute:

• Tigard, OR 97223 (Required)

Work Location: Remote

Salary : $19