We are looking for a Customer Service Representative to assist members and providers with healthcare-related inquiries. The ideal candidate is customer-focused, communicates clearly, and can resolve concerns efficiently while maintaining a high level of professionalism and accuracy.

Key Responsibilities

• Answer inbound customer calls regarding healthcare benefits, claims, eligibility, billing, and provider information.
• Resolve customer concerns and provide accurate information in a timely manner.
• Document customer interactions accurately in company systems.
• Meet established performance, quality, and attendance standards.
• Follow company policies, procedures, and HIPAA compliance requirements.
• Escalate complex issues when necessary.

Performance Expectations

• Maintain high customer satisfaction scores.
• Meet quality assurance and productivity targets.
• Demonstrate strong attendance and schedule adherence.
• Provide accurate and professional customer service on every interaction.

Qualifications

• High school diploma or equivalent.
• Strong communication and problem-solving skills.
• Basic computer and multitasking abilities.
• Customer service experience is preferred.
• Healthcare or call center experience is an advantage but not required.

What We Look For

• Positive attitude and willingness to learn.
• Strong customer service mindset.
• Ability to work in a fast-paced environment.
• Reliability, accountability, and attention to detail.