Remote Healthcare Customer Service Representative - Pennsylvania | WFH

Job Overview

We are seeking a dedicated and customer-oriented Healthcare Customer Service Representative to join our remote team. This role is pivotal in ensuring that our members receive exceptional assistance with policy management, benefits inquiries, and claims processing. If you are motivated by making a meaningful impact in the healthcare sector, we invite you to explore this opportunity with us.

Key Responsibilities
? Process member payments and address billing inquiries.
? Update member records, including contact details and beneficiaries.
? Manage policy termination requests and assist with reinstatements.
? Facilitate ID card orders and ensure prompt delivery.
? Provide comprehensive information regarding coverage plans, eligibility, and benefits.
? Assist members with prior authorizations and referrals, guiding them through necessary procedures.
? Research and verify healthcare provider contact details for timely updates.
? Offer status updates on claims and clarify processing stages.
? Address inquiries related to claim processing and support appeals for denied claims.
? Help members navigate our online portal and resolve any technical issues.
? Maintain confidentiality of member information at all times.
? Escalate complex issues to supervisors as necessary.
? Stay informed about healthcare regulations and policies.
? Collaborate with colleagues to foster a positive and efficient work environment.

Required Skills
? Strong customer service aptitude with a professional demeanor.
? Ability to efficiently manage multiple tasks while demonstrating attention to detail.
? Excellent verbal and written communication skills.
? Proficiency in data entry and online navigation.
? Familiarity with healthcare terminology, claims processing, and benefits is preferred.
? Self-motivated, organized, and capable of both independent and team-based work.

Qualifications
? High School Diploma or GED is required.
? A minimum of two (2) years of experience in claims processing, health insurance, customer service, or a related field.
? Successful completion of a background check is mandatory.

Career Growth Opportunities

Our company is committed to supporting your professional journey through ongoing training and development, ensuring you thrive in your role and advance within the organization.

Company Culture And Values

We pride ourselves on fostering a collaborative team environment that emphasizes professional growth and a mission-driven approach to improving healthcare.

Compensation And Benefits
? Comprehensive benefits package including Medical, Dental, Vision, and Life Insurance.
? Retirement plan options.
? Paid Time Off (PTO).
? A supportive team environment that encourages collaboration and growth.

Employment Type: Full-Time

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