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Client Care Specialist
Client Care SpecialistGlobal Excel • Miami, FL, US
Client Care Specialist

Client Care Specialist

Global Excel • Miami, FL, US
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Hybrid role - Requires going to the Miami office

Job Purpose :

The position exists to oversee Corporate Client requests, respond in a timely manner, and act as a liaison between the client and operational teams or coordinate services to meet client needs.

Responsibilities :

  • Client Care Management (50%)
  • Handle client requests effectively, coordinate activities with operational teams, providers, and suppliers.
  • Maintain accurate documentation of claims, benefits, member information, and client communications.
  • Review and assess activities for each claim, including communication with providers and managing billing and reimbursement requests.
  • Escalate provider issues and coordinate medical appointments.
  • Provide insurance information, contact providers for bill finalization, and perform account reviews and reconciliations.
  • Develop relationships with internal teams and share feedback.
  • Respond to bill queries and payment status inquiries, ensuring high customer service levels.
  • Tools and Resources (45%)
  • Validate incoming communications and documents, ensuring integrity and meeting service targets.
  • Create and validate claims and policies within the system.
  • Interpret system information and respond accurately to clients and providers.
  • Resolve minor escalations, assist with data entry, and support internal queries.
  • Work closely with Claims Team to understand the claims process and support funding and collection activities.
  • Continuous Learning (5%)
  • Familiarize with international healthcare markets and internal responsibilities.
  • Engage in learning opportunities related to systems, processes, and industry awareness.

Success Measures :

  • Achieve quality, accuracy, and performance targets in Client Care Management.
  • Meet internal and external service level targets.
  • Maintain high standards in quality audits and compliance regulations.
  • Participate in and apply learnings from training activities.

    • Major Accountabilities :

  • Oversee claim activities and ensure customer experience standards.
  • Provide timely updates internally and externally.
  • Deliver quality service and escalate complex issues appropriately.

    • Major Challenges :

  • Managing cases across multiple markets with distinct requirements.
  • Navigating international provider requirements.
  • Understanding internal processes and making autonomous decisions in a fast-paced environment.

    • KSA (Knowledge, Skills, Abilities) :

  • Knowledge of healthcare services and billing practices.
  • Proficiency with Microsoft Office and adaptable to new tools.
  • Customer service principles and application.
  • Ability to work independently, organize, prioritize, and multitask.
  • Resourcefulness, decision-making, and interpersonal skills.
  • Excellent communication skills in English and Spanish.

    • Requirements and Qualifications :

  • High school or post-secondary education or equivalent.
  • Minimum two years in customer service and industry experience.
  • Fluent in English and Spanish, both verbal and written.

    • J-18808-Ljbffr

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    Client Care Specialist • Miami, FL, US