Customer Service Representative

Job Summary

Working remotely in a full-time capacity, the Customer Service Representative will assist in resolving customer concerns, provide education and instruction, and maintain customer satisfaction by delivering high-quality service while managing enrollment reports and eligibility issues.

Key responsibilities

• Resolve and reconcile enrollment reports and eligibility issues following policy and state guidelines
• Initiate communication with newly enrolled members and interpret rules and regulations related to contracts and employer groups
• Provide support and advice to member and provider services staff regarding claims issues and assist in claims resolution

Required qualifications

• High School Diploma or Equivalent (GED) required
• Minimum of 1 year of customer service experience required
• Experience with membership data management and reporting preferred
• Knowledge of health plan enrollment processes and eligibility guidelines is a plus