Customer Service Representative

Job Summary

Customer Service Representative, a full-time, hourly position responsible for reviewing grievance and appeals documents, accurately classifying disputes, and entering data into internal systems while adhering to HIPAA regulations.

Key Responsibilities

• Review and assess incoming grievance and appeals documents for completeness and relevance
• Accurately classify dispute types and assign the correct Line of Business based on guidelines
• Access and validate member information across multiple client systems and ensure data accuracy

Required Qualifications

• High school diploma or equivalent
• Experience in customer service or data entry roles
• Familiarity with HIPAA and data privacy regulations
• Ability to work independently and as part of a team
• Willingness to participate in training and quality audits