About Our Client:
The organization operates within the healthcare industry, focusing on improving customer experiences and healthcare delivery. It addresses challenges related to providing effective health insurance customer service and support, serving members, providers, and healthcare vendors across multiple geographic locations. The program emphasizes employee development and fostering a collaborative culture to better serve its community.
About the Opportunity:
The MEMBER CUSTOMER SERVICE REPRESENTATIVE plays a critical role in delivering first-call resolution to members and providers. This position ensures accurate, timely, and empathetic support through inbound and outbound communication, contributing directly to customer satisfaction and operational efficiency. The role also supports adherence to compliance standards and provides a gateway for member-provider interactions, impacting overall healthcare service quality.
Responsibilities:
- Provide inbound and outbound customer service with first call and email resolution.
- De-escalate calls and educate callers with clear, accurate information.
- Conduct routine research to resolve inquiries and provide claims status.
- Escalate issues as needed and document all member interactions thoroughly.
- Route inquiries and paperwork to appropriate departments.
- Maintain confidentiality of personal protected information.
- Meet performance goals, metrics, and attendance standards.
- Perform additional duties as assigned.
Requirements:
- High School Diploma or GED.
- Two years of customer service experience, demonstrating conflict resolution and empathy.
- Proficiency with Microsoft Office or equivalent software and ability to navigate multiple systems during calls.
- Ability to adapt communication style to diverse audiences.
- Willingness to work various shifts as required.
- Preferred: Two years of college coursework or three years of customer service work experience.
- Experience in healthcare, insurance, benefits, or claims processing.
- Experience in call center environments with high volume inbound/outbound calls and recorded screen settings.
Pay Range and Compensation Package:
- The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors.
Benefits & Perks:
- Medical insurance starting day one.
- Employer matched 401(k) plan.
- Pension equity plan.
- Tuition assistance for undergraduate and graduate classes.
- Paid time off policy including eight paid days off annually and two floating holidays.
- One-time pre-tax allotment of $500 for home office furniture upon training completion.
- Twelve weeks of paid virtual training.
- Work from home, full-time schedule with consistent hours.
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.
