Pennsylvania Licensed Customer Service Rep

Job Summary

Assisting in the resolution of customer concerns, the full-time Pennsylvania Licensed Customer Service Rep will manage enrollment reports, provide education to new members, and ensure customer satisfaction while working remotely.

Key responsibilities

• Resolve and reconcile enrollment reports and eligibility issues in accordance with policies and state guidelines
• Initiate communication and provide literature to newly enrolled Health Plan members and employer groups
• Research claim issues and provide support to member and provider services staff regarding claims resolution

Required qualifications

• High School Diploma or Equivalent (GED) required
• Minimum of 1 year of customer service experience required
• Knowledge of Medicaid enrollment processes and eligibility guidelines preferred
• Ability to interpret and apply rules and regulations related to health plan contracts
• Experience with membership data management and reporting tools is beneficial