Customer Services Specialist

Job Description

Job Description

CUSTOMER SERVICE SPECIALIST

Healthcare Customer Service | Member Support | Call Center Operations

Location: Farmington Hills, Michigan
Work Arrangement:  Onsite
Schedule: Full-Time, 40 hours per week
Contract Length: 13 weeks
Anticipated Start Date:  September 14, 2026
Pay Rate: $23.31 per hour

Position Overview

Our client is seeking a dependable and service-focused Customer Service Specialist to assist members across multiple healthcare product lines. This position is responsible for responding to inquiries, investigating concerns, explaining benefits and coverage, and ensuring members receive timely and accurate resolutions.

The ideal candidate has recent customer service or call center experience, strong communication and problem-solving skills, and the ability to handle sensitive information with professionalism and empathy.

Responsibilities

• Respond to member inquiries by telephone, mail, and in person.
• Research and resolve questions, complaints, service issues, and appeals in accordance with established policies and procedures.
• Educate current and prospective members regarding policies, procedures, healthcare products, benefit plans, and coverage provisions.
• Accurately document all incoming inquiries to maintain complete member histories and identify service trends.
• Monitor workflow inboxes and outstanding cases to ensure timely responses and follow-up.
• Contact members by telephone or in writing to provide updates and confirm resolution.
• Coordinate with internal departments to address member needs and resolve service issues.
• Communicate with healthcare providers and their staff to obtain information needed to resolve inquiries and complaints.
• Protect confidential information and maintain compliance with HIPAA and privacy regulations.
• Identify root causes and recurring trends related to service failures.
• Recommend process improvements that enhance member satisfaction, service recovery, and retention.
• Support member enrollment periods, outreach activities, departmental projects, and corporate initiatives.
• Maintain knowledge of changing policies, procedures, products, and department operations.
• Participate in training and continuing education opportunities.
• Perform additional related duties as assigned.

Required Qualifications

• Minimum of two years of recent customer service or call center experience completed within the past three years.
• Associate degree or a minimum of four years of recent, related customer service experience in place of the degree.
• Medical terminology coursework completed or willingness to complete the required course within six months of employment.
• Strong interpersonal, listening, verbal communication, and business writing skills.
• Demonstrated integrity, patience, maturity, empathy, tact, and diplomacy.
• Strong problem-solving skills, sound judgment, flexibility, and commitment to service excellence.
• Ability to manage multiple priorities, cases, and projects accurately and within established deadlines.
• Ability to follow assignments through completion, including appropriate documentation and follow-up.
• Proficiency with computers and Microsoft Office applications.
• Basic understanding of HMO, PPO, and POS healthcare delivery systems and claims billing.
• Ability to work flexible shifts and overtime, including evenings and weekends, when requested or scheduled.
• Dependable attendance and a professional approach to customer service.

Ideal Candidate

The successful candidate will be compassionate, organized, and confident communicating with members, healthcare providers, and internal departments. This individual should be comfortable investigating complex concerns, explaining healthcare information clearly, and working toward solutions that improve the overall member experience.

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