Remote Customer Service Representative

Job Summary

Working remotely on a full-time hourly basis, the Customer Service Representative will review grievance and appeals documents, accurately classify disputes, and manage member information across multiple client systems.

Key responsibilities

• Review and assess incoming grievance and appeals documents for completeness and relevance
• Accurately classify dispute types according to client-specific guidelines and assign the correct Line of Business
• Ensure compliance with HIPAA and data privacy requirements while managing protected health information

Required qualifications

• Experience in customer service or data entry roles
• Familiarity with healthcare regulations and standards
• Ability to navigate multiple client systems and portals
• Strong attention to detail in data entry and document review
• Willingness to participate in training and quality audits