Healthcare Customer Service Specialist

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

📋 Description

• Respond to incoming calls and make outgoing calls to assist members or patients with their inquiries, benefits, scheduling, and service coordination.

• Provide precise information regarding health plan benefits, eligibility, and coverage details.

• Schedule, reschedule, and confirm appointments with healthcare providers.

• Handle referrals, authorizations, prescription renewals, and other related requests.

• Aid members or patients with inquiries related to claims, billing questions, and account updates.

• Assess insurance or plan eligibility and ensure records are updated in the system.

• Maintain accurate documentation in electronic systems, including EMR or CRM tools.

• Communicate effectively with providers and internal teams through phone, secure messaging, or email.

• Safeguard member and patient confidentiality while adhering to HIPAA and relevant privacy guidelines.

• Refer complex issues to the appropriate team or supervisor for resolution.

⛳️ Requirements

• High School Diploma or equivalent required.

• A minimum of 1 year of customer service experience in a call center environment with high call volume.

• At least 1 year of experience in healthcare or health insurance (member services, patient services, provider services, benefits support, or similar roles).

• Previous job tenure of at least 6 months in each role, demonstrating stability and reliability.

• Understanding of privacy regulations and the capability to manage sensitive customer and account information discreetly, ensuring full compliance in a remote work setting.

• Excellent verbal and written communication skills.

• Proficient in navigating multiple systems while maintaining accuracy in call handling.

• Comfortable working in a remote environment with a designated, private workspace.

• Proven stable work history showcasing reliability.

• Dedication to a long-term position and commitment to developing a career within the organization.

• Access to reliable high-speed internet.

🏝️ Benefits

• Medical, Dental, and Vision coverage.

• Life Insurance.

• Short-Term and Long-Term Disability options.

• Flexible Spending Account (FSA).

• Employee Assistance Program.

• 401(k) with employer contribution.

• Paid Time Off (PTO).

• Tuition Reimbursement.