Customer Service Representative II

Job Summary

Providing support to members with complex inquiries, the full-time remote Customer Service Representative II will enhance customer satisfaction by delivering accurate information and building rapport with members, patients, and providers.

Key responsibilities

• Handle diverse member inquiries related to eligibility, benefits, billing, and claims while documenting interactions according to procedures
• Evaluate data to determine appropriate actions for resolving complaints and coordinating service recovery
• Maintain compliance with organizational policies and ensure the privacy and confidentiality of member information

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
• Must pass department-administered Tier II Assessment with a minimum score of 70%
• Strong knowledge of systems used within the Member Service Contact Center
• Ability to manage work with minimal direction and demonstrate analytical and problem-solving skills