Customer Support Specialist - Bilingual

The Specialist provides direct support to our frontline associates and customers. Focused on the customer experience, the specialist manages and resolves customer concerns. The Specialist works closely with support departments and leadership to identify process, product and people related trends allowing the customer support team to track, monitor and recommend actions to replicate successes and address opportunities at an individual, team, and department level.

The Specialist is a Subject Matter Expert and can work independently to resolve complex call and/or claim situations. The Specialist is required to investigate high level escalations and recommend next steps to diffuse escalated situations.

Primary Job Accountabilities/Responsibilities

• Resolves customer concerns, diffuses escalated situations, and resolves complicated cases through multiple channels in a high-volume environment while providing an excellent customer experience.
• Handles, summarizes, and investigates situations as required to support high level escalations and client inquiries
• Demonstrates patience and supports team by answering questions and shows team how to find answers on their own using resources available
• Communicates frequently and effectively to help guide the team through change
• Motivates team members to meet and exceed performance expectations.
• Demonstrates role model behavior, strong communication skills, independence, and efficiency. Supports a culture of respect, collaboration, and professionalism.
• Given higher authorization amounts to make more complicated decisions and may review claims for secondary review and approval
• Participates in and supports employee engagement events, incentives, recognition and activities at the individual, team, department, and site level
• Must have excellent verbal and written communication skills.
• May be occasionally required to provide coaching and feedback that is tailored to a variety of personalities and learning styles
• Supports and provides feedback to supervisors, managers, Business Process Optimization, and other key stakeholders to recommend process improvements
• Ensures accurate and complete tracking of internal and external complaint reporting
• Handles inbound calls and/or adjudicates claims to support our customers and to keep skills fresh
• Assists with potential fraud investigations and collects required supporting documentation
• Collaborates and communicates frequently with support departments including but not limited to legal, compliance, learning and performance optimization, quality, leadership.
• Supports the verification of enrollment process including administrative tracking, research, completing refund calculations accurately and communicating the outcome of the decision verbally and through written correspondence with customers and occasionally clients.
• Compiles internal and external reporting related to escalations, fraud, and verification of enrollment.
• May support special projects such as but not limited to system testing, process walkthroughs, customer support process mapping …