Health Call Center Representative

Job Summary

Providing exceptional customer service, the full-time remote Health Call Center Representative will manage inbound and outbound calls, respond to email inquiries, and deliver accurate information regarding commercial health plan benefits, eligibility, and claims.

Key responsibilities

• Research and respond to inquiries from members and providers while demonstrating patience and empathy
• Manage escalations effectively and coordinate problem-solving with internal departments and external partners
• Document all calls accurately and recognize trends to engage leadership with suggested solutions

Required qualifications

• At least 2 years of customer service experience supporting a commercial health plan
• Knowledge of medical and insurance industry terminology, including CPT/ICD-10 and Revenue Codes
• Proficiency in Microsoft Office applications and prior experience using a CRM, preferably SalesForce
• Ability to work in a fast-paced, deadline-oriented environment
• Must reside in the CST or EST time zones within the United States