Remote Healthcare Customer Service Representative

Job Overview

We are seeking a dedicated Healthcare Customer Service Representative II to join our esteemed team. This fully remote position offers an exciting opportunity to provide exceptional support to our members regarding policy management, benefits, and claims inquiries. Your commitment to delivering clear and professional assistance will enhance the overall customer experience.

Key Responsibilities

• Manage member payments, resolve billing inquiries, and rectify discrepancies.
• Accurately update member details including addresses, phone numbers, beneficiaries, and employment information.
• Process policy termination requests and facilitate reinstatements.
• Track and manage ID card orders.
• Deliver precise information concerning coverage plans, eligibility, benefits, as well as limitations and exclusions.
• Support members with prior authorization and referral processes.
• Provide timely updates regarding claim statuses and processing stages.
• Address questions concerning claim processing, denials, and assist with appeal submissions.
• Facilitate website navigation and troubleshooting for members.
• Respond to general health insurance inquiries with clarity and accuracy.
• Escalate complex matters to supervisors or managers as required.
• Uphold confidentiality and protect sensitive member information.
• Stay current on changes in healthcare regulations, policies, and procedures.
• Collaborate with teammates to cultivate a positive and supportive work atmosphere.
  
  

Required Skills

• Exceptional customer service and communication abilities (verbal and written).
• Strong computer skills, including data entry, screen navigation, and keyboarding proficiency.
• Solid understanding of healthcare terminologies, policy processes, and claims (knowledge of ICD-9 & ICD-10 coding is essential).
• Ability to manage multiple tasks with meticulous attention to detail.
• Self-driven, organized, and capable of working independently or within a team framework.
  
  

Qualifications

• High School Diploma or GED is mandatory.
• Minimum of two (2) years of experience in claims examination, health insurance, customer service, call center, medical office, or a related healthcare domain.
• Candidates must successfully pass a criminal background check.
  
  

Career Growth Opportunities

This position provides a remarkable pathway for professionals aspiring to enhance their careers in healthcare customer service while benefiting from the flexibility of remote work.

Company Culture And Values

We are proud to foster a collaborative and team-oriented work environment where each contribution is valued, and team members feel encouraged to support one another, creating a positive atmosphere.

Compensation And Benefits

• Comprehensive benefits package including Medical, Dental, Vision, and Life Insurance.
• Health Savings Account (HSA).
• 401K retirement plan.
• Paid training to ensure your success in this role.
• Paid Time Off (PTO) promoting a healthy work-life balance.
  
  

If you are enthusiastic about delivering exceptional service and making a difference in the healthcare sector, we invite you to apply today and become a vital part of our dedicated team!

Employment Type: Full-Time