Customer Service Representative II

Job Summary

To enhance customer satisfaction and retention, the full-time remote Customer Service Representative II will manage complex inquiries from members, patients, and providers while building rapport and maintaining compliance with organizational guidelines.

Key responsibilities:

• Handle member inquiries related to eligibility, benefits, billing, and claims, ensuring accurate and timely responses
• Document all interactions and follow established procedures to resolve complaints and coordinate service recovery
• Collaborate with internal and external stakeholders to gather necessary information and support customer needs effectively

Required qualifications:

• Minimum of 2.5 years of customer service experience, including at least 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
• Proven ability to manage work with minimal direction and demonstrate analytical skills