Customer Service Representative

Job Summary

Working remotely on a full-time hourly basis, the Customer Service Representative will manage the review and processing of Grievance and Appeals documents, ensuring compliance with client guidelines and regulatory definitions.

Key responsibilities

• Review incoming Grievance and Appeals documents for completeness and relevance
• Accurately classify dispute types and assign the correct Line of Business based on client definitions
• Access multiple systems to verify member information and enter data accurately into internal platforms

Required qualifications

• Experience with Facets preferred
• Ability to adhere to HIPAA and data privacy regulations
• Familiarity with client-specific workflows and standard operating procedures
• Strong attention to detail in data entry and document processing
• Availability for a 2-week training period, Monday to Friday, 9:00 AM to 5:30 PM EST