Remote Healthcare Customer Service Representative - Pennsylvania | WFH

Job Overview

We are seeking a dedicated and skilled Healthcare Customer Service Representative to join our esteemed team. This remote position is ideal for professionals who are passionate about delivering exceptional customer service while supporting members with their policy management, benefits inquiries, and claims-related questions. Your exemplary communication skills will play a crucial role in enhancing the member experience within our healthcare service framework.

Key Responsibilities
• Policy Management:
• Manage member payments, resolve billing inquiries, and rectify discrepancies.
• Update member records, including contact details and beneficiary information.
• Process policy terminations and reinstatements efficiently.
• Handle ID card orders and address associated concerns.
• Benefits Assistance:
• Provide clear and accurate information regarding coverage plans and eligibility.
• Facilitate prior authorizations and referral processes.
• Conduct research to ensure members possess correct contact information for healthcare providers.
• Claims Support:
• Offer timely updates on claims and elucidate processing stages.
• Address inquiries related to claim denials and assist members in the appeals process.
• Support reconsideration requests and compile necessary documentation.
• General Inquiries & Technical Support:
• Assist members in navigating the member website and troubleshooting any issues.
• Respond to general inquiries regarding health insurance plans.
• Escalate complex matters to supervisory staff when necessary.

Required Skills
• Exceptional customer service and communication skills, both verbal and written.
• Strong attention to detail with the capability to multitask effectively.
• Proficient in computer systems, including data entry and screen navigation.
• Knowledgeable in healthcare terminology, benefits, medical claims, and policy processes.
• Ability to work both independently and collaboratively in a remote work environment.
• Excellent time management and problem-solving abilities.

Qualifications
• A minimum of 2 years of experience in healthcare customer service, claims processing, call center operations, or a medical office setting.
• High school diploma or GED is required.
• Must successfully pass a background check.

Career Growth Opportunities

We offer comprehensive training programs designed to equip you for success, paving the way for potential advancements within the healthcare sector.

Company Culture And Values

Our organization champions a collaborative remote work environment, where teamwork and effective communication are highly valued. We pride ourselves on our commitment to exemplary customer service and support.

Compensation And Benefits
• Competitive salary based on experience.
• Comprehensive benefits package, including medical, dental, vision, life insurance, and retirement plans.
• Paid time off to ensure a balanced work-life integration.
• A supportive and collaborative remote work atmosphere.

If you aspire to make a significant impact in the healthcare industry, we encourage you to apply today and join our mission to provide excellent service to our members.

Employment Type: Full-Time

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