This is a fully remote position, open to applicants in United States.

📋 Description

• Engage with providers and members in a timely and professional manner through various channels, including inbound and outbound calls, emails, live chat, and other platforms.

• Address inquiries with empathy, precision, and a calm demeanor.

• Provide clear and accurate information that aligns with company policies and procedures.

• Escalate complex issues to leadership when necessary.

• Accurately document interactions, feedback, and resolutions in CRM or case management systems.

• Share insights on recurring problems to support process enhancement.

• Collaborate with team members and supervisors to ensure coordinated support.

• Direct issues to the appropriate departments.

• Research claims and verify insurance coverage as needed.

• Resolve inquiries while ensuring compliance with healthcare regulations.

• Adhere to established scripts and guidelines to deliver high-quality contact experiences.

⛳️ Requirements

• A high school diploma or GED is required.

• 1–2 years of customer service experience, preferably in the healthcare sector.

• Strong organizational and communication skills are essential.

• A keen attention to detail is required.

• Ability to actively listen, demonstrate empathy, and respond to concerns from members and/or providers with compassion and clarity.

• Capable of multitasking and navigating multiple systems simultaneously.

• Availability to work from 8:00 AM to 4:30 PM or 8:30 AM to 5:00 PM EST.

• Ability to meet or exceed key performance indicators (KPIs), including call quality, handle time, customer satisfaction, adherence to scripts, quality standards, and scheduled work hours.