Job Description

Position: Customer Service Representative – Health Care Benefit Administrator

Must have customer service experience. Healthcare or medical experience preferred, but not required.

Job Description:

We are seeking a Customer Service Representative to support our specialty medical benefits team. As the first point of contact for our members and providers, this role is critical in creating a positive and professional first impression.

Key Responsibilities:

• Answer incoming phone calls from members and healthcare providers promptly and professionally, addressing questions related to benefits, policies, coverage, and claims.
• Communicate clearly and concisely about our healthcare service offerings across all product lines.
• Provide exceptional service to both members and providers by building rapport and maintaining professionalism in every interaction.
• Respond to inquiries via phone, virtual communication, or email in a courteous and timely manner.
• Handle escalated issues and work to resolve concerns to ensure customer satisfaction.
• Accurately document all member and provider interactions and resolutions.
• Adhere to insurance regulations and HIPAA compliance standards.
• Collaborate with internal teams to coordinate timely and appropriate responses to inquiries.

Qualifications:

• Previous customer service experience is required.
• Basic knowledge of medical or health benefits is preferred.
• Strong computer and data entry skills.
• Familiarity with HIPAA regulations.
• Ability to work independently in a fast-paced environment.
• Strong problem-solving skills and attention to detail.
• Excellent time management and organizational abilities.
• Clear and professional verbal and written communication skills.

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