Customer Service Representative I – Claims

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

📋 Description

• Aids in addressing customer issues and ensuring customer satisfaction.

• Engages in cross-training and enhances processes within the Customer Service team.

• Manages and reconciles enrollment reports along with associated eligibility concerns.

• Initiates outreach to newly enrolled Health Plan members.

• Analyzes rules and regulations within contractual agreements.

• Generates membership data extract reports for employer groups.

• Assesses member eligibility and processes terminations accordingly.

• Prepares and distributes communications related to enrollment activities.

• Reviews suspended claims for resolution and offers support to staff.

⛳️ Requirements

• High School Diploma or Equivalent (GED) - (Mandatory)

• At least 1 year of experience in Customer Service - (Mandatory)

🏝️ Benefits

• Healthcare benefits available from day one, including vision and dental coverage.

• Benefits extend to domestic partners.

• A collaborative and collegial work environment.