Customer Service Representative II

Job Summary

Providing exceptional support to members and customers, the full-time remote Customer Service Representative II will manage complex inquiries related to health plan services, billing, and claims while ensuring customer satisfaction and compliance with organizational guidelines.

Key responsibilities:

• Handle member inquiries across various service categories, including eligibility, billing, and claims
• Document and evaluate customer interactions to implement appropriate resolutions and service recovery
• Collaborate with internal and external teams to obtain necessary information and support customer needs

Required qualifications:

• Minimum of 2.5 years of customer service experience, including 6 months as a Customer Service Representative I
• High School Diploma or General Education Diploma (GED) required
• Ability to pass department-administered Tier II Assessment with a minimum score of 70%
• Strong knowledge of systems used within the Member Service Contact Center
• Demonstrated ability to manage work with minimal direction and effectively communicate with diverse teams