Customer Experience & Benefits Navigator

Liberty Healthcare Management; Wilmington (NC); On-site; USD 36,000 - 58,000; Full time

Job summary

Liberty Healthcare Management in Wilmington, NC, is seeking an experienced Customer Service Specialist to support Liberty Advantage. You will handle escalated calls, educate members on benefits, and coordinate with providers to resolve issues.

This full-time role requires at least 3 years of relevant experience, excellent communication, confidentiality, and the ability to work independently with strong follow-up.

Qualifications

• 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.

Responsibilities

• Handle escalated calls from members/providers or vendors resolving issues, preferably the first time.
• Educate members on the benefits available, resolving claim information, setting up enhanced benefits.
• Intervene with care providers on behalf of the customer to assist with appointment scheduling or connections with internal specialist.
• Assist with enrollment team to set up new members.
• Document and resolve Appeals and Grievances within CMS time frames.
• Research complex issues across multiple databases and collaborate to resolve escalated issues.
• Set-up and triage prior authorization requests, working through clinical protocols.

Skills

Customer service

Communication skills

Problem solving

Time management

Job description

Liberty Healthcare Management in Wilmington, NC, is seeking an experienced Customer Service Specialist to support Liberty Advantage. You will handle escalated calls, educate members on benefits, and coordinate with providers to resolve issues.

This full-time role requires at least 3 years of relevant experience, excellent communication, confidentiality, and the ability to work independently with strong follow-up.