Health Call Center Representative

Job Summary

To support its significant growth, the full-time remote Health Call Center Representative will provide accurate information on commercial health plan benefits, handle inbound and outbound calls, and respond to customer inquiries while ensuring an exceptional service experience.

Key responsibilities

• Research and respond to inquiries from members and providers regarding health plan benefits and claims
• Effectively manage escalations and coordinate problem-solving with internal departments and external partners
• Document all calls accurately and recognize trends to suggest improvements to leadership

Required qualifications

• At least two 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 experience with CRM systems, preferably SalesForce
• Ability to work in a fast-paced environment and manage multiple tasks effectively
• Must reside in the CST or EST time zones within the United States