Customer Service Representative II

Job Summary

To enhance customer satisfaction and retention, the full-time remote Customer Service Representative II will manage complex inquiries and provide accurate information to members, patients, and providers while building rapport and ensuring compliance with guidelines.

Key responsibilities

• Handle member inquiries related to eligibility, benefits, billing, claims, and service reviews
• Document conversations and coordinate with relevant departments to resolve customer issues effectively
• Promote exceptional customer service in alignment with organizational standards and compliance requirements

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
• 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 skills