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 timely, accurate information to members, patients, and providers while adhering to compliance guidelines.

Key responsibilities:

• Handle member inquiries related to eligibility, benefits, billing, and claims while documenting all interactions
• Evaluate and resolve complaints by coordinating with relevant health plan personnel and implementing appropriate actions
• Support department goals by effectively interacting with diverse work units and ensuring compliance with organizational policies

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 a Classification Assessment and maintain a typing speed of 30 WPM
• Strong knowledge of systems used within the Member Service Contact Center
• Ability to manage work with minimal direction and pass knowledge checks during training