Job Description

MUST HAVE REQUIREMENTS

• Strong knowledge and understanding of Explanation of Benefits (EOB)
• Extensive experience interfacing with payors
• Strong understanding of claims eligibility
• Amazing interpersonal and phone skills
• MUST be local to San Diego and able to commute daily to Sorrento Valley
• Hours are Monday through Friday, 7:00 am to 3:30 pm

SUMMARY

Our client is seeking a motivated and detail-oriented individual to join their team as a Customer Experience Specialist I. This role involves supporting innovative services aimed at transforming care for various medical conditions, including Inflammatory Bowel Disease and autoimmune diseases. The specialist will report directly to the Customer Experience Supervisor and collaborate closely with Billing, Sales, and other departments to achieve commercial and financial objectives. The primary focus will be on delivering exceptional customer service to maintain long-term relationships and ensure customer retention.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Handle inbound and outbound phone inquiries with efficiency and professionalism.
• Foster a customer-focused culture across the organization.
• Resolve client inquiries promptly, ensuring first-contact resolution.
• Collaborate with internal teams to address customer needs and improve processes.
• Document case details to support business operations and track progress.
• Identify and escalate any account-level issues to leadership as needed.
• Contribute to process improvements to enhance the customer experience.
• Address escalated inquiries or complaints in a timely manner.
• Ensure compliance with all relevant policies and standards in customer interactions.
• Coordinate with field sales to ensure a seamless ordering process for customers.
• Represent Customer Experience in internal meetings and presentations.
• Manage multiple tasks and projects simultaneously, while maintaining strong organizational skills and a sense of urgency.

QUALIFICATIONS

• High School Diploma or equivalent required; Bachelor’s degree preferred.
• Minimum of 4 years of experience in customer service or a related field.
• Proficiency with CRM systems, billing platforms, and Microsoft Office Suite.
• Excellent communication skills in English; bilingual proficiency is a plus.
• Strong problem-solving and decision-making skills.
• Ability to work independently and as part of a team in a fast-paced environment.

WORK ENVIRONMENT

This position operates primarily in an office environment. The role requires sitting, talking, and hearing on a regular basis. Occasional standing, walking, or lifting up to 25 lbs may be required. Specific vision abilities required include close vision, peripheral vision, depth perception, and the ability to adjust focus.

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