Call Center Customer Service Representative - Healthcare - Eligibility & Claims
Posted 2025-04-06Job description
Healthcare Customer Service Representative
Transparent Health Group is a rapidly growing healthcare benefit services company that provides the services and technology necessary to make complex health plans work for its members. We ensure employers and their employees have the information they need to make informed decisions about their healthcare benefits. Our goal is to eliminate surprises in our members' healthcare coverage!
The Call Center Representative answers phones promptly and professionally and is responsible for providing eligibility, benefits, and claim status. The ideal candidate has strong customer service and communication skills with the ability to work efficiently in a fast-paced environment.
Position Overview
 Abide by all HIPAA requirements
 Heavy Inbound Call Volume - Providers
 Confirm Benefits and Eligibility
 Ability to read and understand Benefit Overviews
 Respond to Claim Inquiries via phone and email
 Familiar with reading Explanation of Benefits (EOBs)
 Meet and Adhere to all KPI metrics
 Ability to complete daily tasks in between calls
 Adhere to policies and procedures
Why Work with Us
 100% remote, work-from-home position
 Benefits are available on day 1 of employment which include medical, vision, and dental
 In-depth training program to guarantee success in your position
 Fast-growing company
 Opportunities for advancement
 Supportive team-based workplace
 3 weeks of PTO plus 8 paid company holidays
 Monday-Friday position, no weekends!
 Our family values mean we are committed to a real living wage, with meaningful benefits
Requirements
 Experience working in health insurance
 Must possess a high level of organization, reliability, and attention to detail
 Phone-based customer service call center experience (High call volume)
 Comfortable working with technology
 Exceptional verbal and written communication skills
 Outstanding track record of attendance and adherence to schedule
 Proper utilization of resources
 Accept feedback in a positive manner
 Quiet and private home working environment, where you can work uninterrupted for the duration of your shift
 Self-starter who demonstrates working independently
 Reliable high-speed Internet access required
 Successful multitasker who can ensure all responsibilities are completed on time
Personal Attributes Needed for Success
 Ability to build rapport with a wide range of people
 Excellent follow-up and follow-through skills
 Strong desire to be of service and assist others
 Motivated by being in a supportive role and contributing to team success
 Bilingual a plus! English and Spanish, English and Chinese, English and Mandarin, English and Russian
 Familiarity with Indemnity Plans a PLUS!
Job Type: Full-time
Pay: $17.00 - $19.00 per hour
Benefits:
 401(k)
 401(k) matching
 Dental insurance
 Health insurance
 Life insurance
 Paid time off
 Referral program
Schedule:
 8 hour shift
 Day shift
 Monday to Friday
Application Question(s):
 Do you have any familiarity with Indemnity Plan?
Experience:
 Call Center/Heavy Phone: 1 year (Required)
 Medical Insurance: 1 year (Required)
 Customer Service: 1 year (Required)
Work Location: Remote
Apply Job!