Member Care Resolution Expert

CareSource; Kentucky; Hybrid; USD 65,298,000 - 104,698,000; Full time

Job summary

CareSource is seeking a Customer Care Resolution Specialist in Kentucky to serve as a subject matter expert for the assist line, handling escalated calls from members and providers. The role includes coaching new hires, identifying process gaps, and partnering with internal teams to improve service levels.

We expect a strong background in customer care, call-center experience, and knowledge of Medicaid or related health plan processes.

Qualifications

• High School diploma or equivalent required.
• Minimum of one year experience in Customer Care (Member Services or Provider Services) required.
• Minimum of three years customer service experience in a call center preferred.
• Minimum of two years of HMO or related industry experience preferred.

Responsibilities

• Act as SME, staff assist line and respond to inquiries.
• Resolve escalated calls from members and providers.
• Serve as New Hire Transition Coach for new employees.
• Identify process gaps and partner with Business Integration Team to resolve.
• Provide Peer-to-Peer feedback and identify training needs.

Skills

Customer Care processes

Deescalation skills

Problem solving

Communication skills

Team collaboration

Attention to detail

Multitasking

PHI/ HIPAA compliance

Education

High School diploma or equivalent

Job description

CareSource is seeking a Customer Care Resolution Specialist in Kentucky to serve as a subject matter expert for the assist line, handling escalated calls from members and providers. The role includes coaching new hires, identifying process gaps, and partnering with internal teams to improve service levels.

We expect a strong background in customer care, call-center experience, and knowledge of Medicaid or related health plan processes.