Customer Service Representative

Job Summary

Working remotely full-time, the Customer Service Representative will provide inbound and outbound support to members and providers, ensuring first call resolution while managing claims inquiries and documentation.

Key responsibilities

• Deliver first call resolution and customer education through effective communication and problem-solving
• Document and follow up on customer issues, routing inquiries to appropriate departments as necessary
• Maintain compliance with Personal Protected Information (PPI) requirements while handling sensitive information

Required qualifications

• High School Diploma or GED
• Two years of customer service experience in related fields
• Demonstrated recent experience with Microsoft Office Suite or equivalent software platforms
• Ability to adapt communication style to diverse audiences
• Experience in healthcare, insurance, or claims processing industries preferred