Job Description

Are you passionate about helping others and looking for a rewarding career in healthcare? We're looking for a Healthcare Customer Service Representative to join our team! In this role, you'll play a key part in assisting members with policy management, benefits, and claim inquiries—all while providing excellent customer service.

This is a full-time, 100% remote position with a supportive team and opportunities for growth.

What You'll Do:
Policy Management
Process member payments, resolve billing inquiries, and address discrepancies.
Update member information, including addresses, phone numbers, and beneficiary details.
Handle policy terminations, reinstatements, and ID card requests efficiently.
Benefits Assistance
Provide accurate information about coverage, eligibility, and plan details.
Assist members with prior authorization and referral processes.
Research and confirm healthcare provider contact details for members.
Claims Support
Give timely updates on claim statuses and help members understand the process.
Explain claim denials and guide members through appeals and reconsideration requests.
General Assistance
Help members navigate the online portal and resolve technical issues.
Answer general questions about healthcare plans and policies.
Escalate complex issues to the appropriate team for resolution.
What We're Looking For:
Excellent customer service skills - a friendly and professional approach.
Ability to follow schedules and manage daily tasks efficiently.
Strong oral and written communication skills.
Tech-savvy - comfortable with data entry, screen navigation, and troubleshooting.
Solid understanding of healthcare terminology, claims, eligibility, benefits, and coding (ICD-9 & ICD-10).
Detail-oriented and organized, with strong problem-solving skills.
Ability to work independently and as part of a team.
What You Need to Apply:
High school diploma or GED required.
At least two years of experience in healthcare customer service, claims processing, or a related field.
Ability to pass a criminal background check.
Work-From-Home Requirements:
High-speed internet (minimum 25 Mbps download / 5 Mbps upload) - a speed test may be required.
Ability to hardwire your connection to your modem.
A quiet, dedicated workspace.
What We Offer:
Paid training to set you up for success.
Comprehensive benefits package, including medical, dental, vision, life insurance, and 401K.
Paid time off (PTO) to support work-life balance.
If you're ready to make a difference and grow your career in healthcare, we'd love to hear from you! Apply today!
Employment Type: Full-Time
Salary: $ 17.00 19.00 Per Hour

Job Tags

Hourly pay, Full time, Remote job,

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