Commercial Health Call Center Representative - Remote

Overview

The Commercial Health Call Center Representative is responsible for responding to inquiries from members and providers, ensuring effective communication and resolution of issues in a remote work environment.

In Short

• Research and respond to inquiries from members and providers.
• Employ active listening skills and handle difficult calls professionally.
• Manage escalations effectively within the department.
• Utilize company policies to provide accurate information.
• Document all calls accurately.
• Assist members with navigating the member portal.
• Meet department production and quality standards.
• Participate actively in a virtual work environment.
• Recognize trends in call types for improvement.
• Work with internal departments to coordinate problem-solving.

Requirements

• Minimum of 2 years of customer service experience in health plans.
• Experience in supporting operational units like Claims and Appeals.
• Knowledge of medical and insurance terminology.
• Excellent verbal and written communication skills.
• Strong attention to detail and problem-solving abilities.
• Proficiency in Microsoft Office applications.
• Prior experience with CRM, preferably SalesForce.
• Fluency in Spanish is a bonus.

Benefits

• Competitive salary.
• Comprehensive health, dental, and vision insurance.
• Retirement savings plan with company match.
• Generous time off/vacation.
• Professional development opportunities.
• Flexible and remote work environment.