Customer Service Agent – Tier 1 - Remote

Overview

As a Tier 1 Customer Service Agent, you will be the first point of contact for members and providers, handling inbound calls during your assigned shift. This role requires excellent communication skills, attention to detail, and a service-first mindset to resolve inquiries efficiently and professionally.

In Short

• Be available and responsive throughout the assigned shift to handle inbound calls.
• Provide accurate information regarding member benefits and eligibility.
• Advise callers on the status of submitted claims.
• Assist in locating in-network healthcare providers.
• Maintain a high level of professionalism and empathy in every interaction.
• Document call details clearly and accurately in internal systems.
• Adhere to company protocols and service level standards.

Requirements

• 1 year of experience in the healthcare insurance industry is preferred.
• 1 year of experience in Customer Service is required.
• Available to work an 8-hour shift with a set schedule.
• Strong problem-solving skills and attention to detail.
• A customer-oriented mindset with a focus on providing high-quality service; patience and empathy when dealing with customers.
• Great organizational skills with the ability to prioritize tasks and manage multiple priorities simultaneously.
• A flexible mindset with the ability to adapt to changing circumstances and shift priorities at a moment’s notice.
• Demonstrates professionalism in all interactions and maintains a positive attitude under pressure.
• Familiarity with CRM and ticketing systems; experience with Salesforce is a plus.
• Proficient in using computer applications (Google Suite preferred).
• Understanding of HIPAA and ability to handle sensitive and confidential information with care and discretion.
• Strong communication skills, both verbal and written. Fluent in English; Bilingual a plus.
• Legally authorized to work in the US.

Benefits

• Competitive compensation, bonuses, and benefit packages.
• PTO (unlimited or 3 weeks accrued depending on the role).
• 401K match.
• Work from home reimbursement to set up your home office.