• Handle high-volume inbound calls with professionalism, empathy, and accuracy. • Provide clear, accurate information regarding health insurance benefits, claims, billing, and eligibility. • Assist members in navigating online resources and submitting requests. • Document all call interactions in customer management systems in compliance with company and regulatory requirements. • Adhere to call handling standards, including average handle time, quality scores, and first call resolution targets. • Follow compliance guidelines including HIPAA, CMS, and state-specific regulations. • Escalate complex issues appropriately to ensure timely resolution. • Stay current with updates to health plan policies, systems, and processes. • Contribute to continuous improvement by identifying trends and opportunities for enhanced customer experience.