Customer Service Representative I
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Job Summary
Providing essential support in claims resolution, the full-time Customer Service Representative I will assist customers with inquiries, review suspended claims, and collaborate with team members to ensure the highest level of customer satisfaction while working remotely from Pennsylvania.
Key responsibilities:
- Determine coverage of services received based on applicable policies and product design
- Review and resolve suspended claims by applying current procedures and benefits
- Support member and provider services staff with daily claims-related advice and resources
Required qualifications:
- High School Diploma or Equivalent (GED) required
- Minimum of 1 year of customer service experience required
- Familiarity with claims processing and resolution policies preferred
- Experience in a healthcare or insurance environment is a plus
- Ability to collaborate effectively within a team setting
Complete Job Description
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