Receive calls, respond to workflows and chat to answers basic to moderately complex questions from policyholders, medical providers, and sales agents on life, preneed, or health (such as Medicare supplement, dental, vision, hearing, Hospital Indemnity & Ancillary Products) policies such as claims, benefits, and premiums while protecting privacy as outlined by state and federal regulations.
Receive and process basic to moderately complex changes such as premium refunds, deductible changes, co-insurance changes, network changes, refunds premiums, reconciliation, balancing, removing dependents, standard terminations and other related items.
Document all aspects of customer claims to ensure file has all information required to fulfill policyholder and/or provider requests.
Occasionally research systems, websites, and work with internal departments to accurately follow-up with and resolve basic to moderately complex policyholder and provider complaints and concerns, escalating issues appropriately to more experienced peers to resolve more complex issues and assisting peers through chat lines as needed.
Plan, coordinate, and execute basic to moderately complex projects to support the business.
Train, mentor, support, and develop less experienced customer success representatives by providing advice, coaching and educational opportunities.

High school diploma or GED equivalence
1+ year customer service or related experience
Insurance industry experience, a plus
Working knowledge of the principles, processes, and practices related to customer success
Ability to meet and maintain metrics of a Customer Success Specialist 2; including First Call Resolution, efficiency, quality, productivity, core competencies, etc.
Average accuracy on judgement for policies, requests, and documentations with a working attention to detail
Strong verbal and written communication skills with the ability to respond effectively to both internal and external customers
Active listening skills with ability to understand concern and ask relevant questions
Ability to maintain policyholders, medical providers, and sales agents’ privacy by following state and federal regulations
General knowledge of MS Office (Excel, Word, Outlook).

Customer Success Specialist

Key skills