Our client, a local insurance and healthcare network focused on helping patients make the most of their coverage, is seeking professional and service-oriented Health Plan Specialists to join their team!
... As a Health Plan Specialist, you will be the first point of contact for health plan members, providers, and group representatives, providing excellent customer service via telephone, and answering a wide range of inquiries about products, benefits, and provider networks.
This role will utilize your problem-solving skills and technology to resolve both simple and complex issues, and to de-escalate emotionally charged situations while ensuring all interactions and decisions comply with departmental and regulatory requirements.
Highlights:
Responsibilities:
Educate and inform members about their available health plan benefits and coordinate information exchange with providers and internal departmentsInstruct members on how to maximize their benefit reimbursement, including the advantages of using their primary care physician and network providersResearch and determine the various policy provisions, guidelines, and procedures that apply to a callers situationUtilize various information databases to research, provide answers, and make appropriate decisions for each callerDocument each phone call according to departmental standards and report trends or concerns to managementStay up-to-date on all regulatory, compliance, and departmental changes to meet metric requirementsPerform other duties as assignedQualifications:
Must be located within driving distance to Madison, WIHigh school diploma or equivalent requiredPrevious call center or professional customer service experience preferredExcellent verbal and written communication skillsAbility to understand health plan products and detailsComputer proficiency and ability to learn various software programsMust be able to meet technical requirements to be discussed during interview processMust meet technical requirementsPlease apply to the Health Plan Specialist for immediate consideration!
#SPH1001
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
Our client, a local insurance and healthcare network focused on helping patients make the most of their coverage, is seeking professional and service-oriented Health Plan Specialists to join their team!
As a Health Plan Specialist, you will be the first point of contact for health plan members, providers, and group representatives, providing excellent customer service via telephone, and answering a wide range of inquiries about products, benefits, and provider networks.
This role will utilize your problem-solving skills and technology to resolve both simple and complex issues, and to de-escalate emotionally charged situations while ensuring all interactions and decisions comply with departmental and regulatory requirements.
... Highlights:
Responsibilities:
Educate and inform members about their available health plan benefits and coordinate information exchange with providers and internal departmentsInstruct members on how to maximize their benefit reimbursement, including the advantages of using their primary care physician and network providersResearch and determine the various policy provisions, guidelines, and procedures that apply to a callers situationUtilize various information databases to research, provide answers, and make appropriate decisions for each callerDocument each phone call according to departmental standards and report trends or concerns to managementStay up-to-date on all regulatory, compliance, and departmental changes to meet metric requirementsPerform other duties as assignedQualifications:
Must be located within driving distance to Madison, WIHigh school diploma or equivalent requiredPrevious call center or professional customer service experience preferredExcellent verbal and written communication skillsAbility to understand health plan products and detailsComputer proficiency and ability to learn various software programsMust be able to meet technical requirements to be discussed during interview processMust meet technical requirementsPlease apply to the Health Plan Specialist for immediate consideration!
#SPH1001
Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion.
Equal Opportunity Employer: Race, Color, Religion, Sex, Sexual Orientation, Gender Identity, National Origin, Age, Genetic Information, Disability, Protected Veteran Status, or any other legally protected group status.
At Spherion, we welcome people of all abilities and want to ensure that our hiring and interview process meets the needs of all applicants. If you require a reasonable accommodation to make your application or interview experience a great one, please contact Callcenter@spherion.com.
Pay offered to a successful candidate will be based on several factors including the candidate's education, work experience, work location, specific job duties, certifications, etc. In addition, Spherion offers a comprehensive benefits package, including: medical, prescription, dental, vision, AD&D, and life insurance offerings, short-term disability, and a 401K plan (all benefits are based on eligibility).
- Educate and inform members about their available health plan benefits and coordinate information exchange with providers and internal departments- Instruct members on how to maximize their benefit reimbursement, including the advantages of using their primary care physician and network providers- Research and determine the various policy provisions, guidelines, and procedures that apply to a callers situation- Utilize various information databases to research, provide answers, and make appropriate decisions for each caller- Document each phone call according to departmental standards and report trends or concerns to management- Stay up-to-date on all regulatory, compliance, and departmental changes to meet metric requirements- Perform other duties as assigned
experience0-1 years
skills- Previous call center or professional customer service experience preferred
educationHigh School
share this job.