Health Plan Specialist - Commercial

We are looking for a customer-focused Health Plan Specialist to support member inquiries. In this role, you will respond to inbound calls from individuals seeking guidance on benefits, billing, and enrollment, while delivering clear, accurate, and compassionate service. This position is ideal for someone who thrives in a fast-paced call center setting, can manage high call volumes during open enrollment, and takes pride in resolving issues thoroughly from start to finish.

Responsibilities:

• Handle a high volume of inbound member calls, addressing questions related to health plan benefits, premium billing, eligibility, and enrollment details.
• Take full ownership of each inquiry by researching concerns, documenting interactions carefully, and ensuring issues are resolved completely and on time.
• Use available systems, reference materials, and online resources to provide accurate information and support sound member decisions.
• Deliver respectful, attentive service in every interaction while demonstrating empathy and a strong commitment to the member experience.
• Manage complex situations with careful problem-solving, clear explanations, and appropriate follow-up when additional action is required.
• Maintain detailed and organized records to support quality standards, compliance expectations, and continuity of service.
• Participate in virtual training, team meetings, and coaching activities, including camera-on sessions in a remote work environment.
• Follow assigned scheduling requirements, including flexibility to work various shifts Monday through Friday and Saturday hours as needed during business demand.
• Support peak seasonal workloads, including open enrollment periods, by consistently meeting productivity, attendance, and service expectations.
• High school diploma or equivalent work experience in place of formal education.
• At least 2 years of experience in a call center environment with direct customer support responsibilities.
• Ability to communicate clearly and professionally in both spoken and written formats.
• Strong computer proficiency, including Microsoft Office, dual-monitor setups, and working across multiple applications at the same time.
• Demonstrated ability to analyze issues, verify information, and resolve member concerns with accuracy and professionalism.
• Reliable attendance and the ability to maintain performance in a structured, fast-paced service environment.
• Hard-wired high-speed internet connection with ethernet capability; satellite, hotspot, and Wi-Fi-only connections are not acceptable.
• Ability to maintain a distraction-free remote workspace and participate on camera for virtual meetings and training.