Member Support Specialist – Health Benefits Navigator

Detego Health; Omaha (NE); Presencial; USD 29 000 - 33 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Health insurance

401(k) matching

Employee assistance program

Paid time off

Vision insurance

Resumo da oferta

Detego Health in Omaha, NE is seeking a Customer Service Member Support Rep to be the frontline member advocate. You will assist members with eligibility, benefits, claims, billing, and provider networks while delivering an empathetic, professional experience.

Document interactions in Salesforce, educate members about coverage, perform outbound follow-ups, and escalate complex issues as needed. This non-clinical, in-person capable role requires strong communication, accuracy, and a commitment to

Qualificações

• Excellent customer service, communication, active listening, conflict resolution, and de-escalation skills.
• Ability to build rapport and provide an exceptional member experience.
• Capacity to work in a fast-paced, metrics-driven call center environment.
• Strong documentation, data entry, and CRM skills.

Responsabilidades

• Serve as the first point of contact for member inquiries via phone, email, and other approved channels.
• Deliver a positive, professional, empathetic, member-focused experience during every interaction.
• Verify member identity and protect confidential information in accordance with HIPAA and privacy requirements.
• Educate members regarding eligibility, enrollment, benefits, claims, billing, provider networks, and resources.
• Research and resolve routine member inquiries using approved systems and knowledge bases.
• Document all member interactions in Salesforce CRM and other required systems.
• Conduct outbound calls for follow-up, education, issue resolution, and member engagement.
• Escalate complex, sensitive, or unresolved issues to appropriate internal resources.
• Meet departmental standards for quality, productivity, average handle time, and accuracy.

Conhecimentos

Customer service

Communication

Active listening

Conflict resolution

De-escalation

Rapport building

Problem solving

Data entry

CRM software

HIPAA compliance

Ferramentas

Salesforce CRM

Descrição da oferta de emprego

Detego Health in Omaha, NE is seeking a Customer Service Member Support Rep to be the frontline member advocate. You will assist members with eligibility, benefits, claims, billing, and provider networks while delivering an empathetic, professional experience.

Document interactions in Salesforce, educate members about coverage, perform outbound follow-ups, and escalate complex issues as needed. This non-clinical, in-person capable role requires strong communication, accuracy, and a commitment to