**Experienced Customer Service Representative - Remote Healthcare Support Specialist**

Join our dynamic team and be part of our mission to revolutionize healthcare affordability for patients and restore the fulfillment of practicing medicine for providers. As a Customer Service Representative, you'll play a pivotal role in delivering exceptional customer service to our clients and members, ensuring seamless interactions and fostering long-term relationships. **About Us** At [Company Name], we're committed to transforming the healthcare landscape by providing innovative solutions that prioritize patient care and provider satisfaction. Our team of dedicated professionals shares a passion for excellence, and we're seeking like-minded individuals to join our mission. With a strong focus on customer-centricity, we strive to create a supportive environment where our team members can grow, learn, and thrive. **Your Responsibilities** As a Customer Service Representative, you'll be responsible for: * Answering incoming calls promptly and professionally, offering skilled problem-solving and meeting set quality standards. * Demonstrating courtesy and professionalism while providing accurate information to callers, ensuring a positive experience for our clients and members. * Handling client and member inquiries related to claims payment, status, and coverage information with expertise, providing timely and effective resolutions. * Interpreting and following client health plan protocols efficiently, ensuring seamless interactions and minimizing errors. * Assisting in claims processing by backing up the claims processing area with reports and workflow queues as assigned, maintaining accurate and up-to-date records. * Checking and maintaining accurate tracer documentation, ensuring compliance with regulatory requirements. * Ensuring complete and detailed call documentation, facilitating efficient issue resolution and quality improvement. * Maintaining a high level of professionalism in all interactions, upholding our company's values and reputation. * Promptly returning incoming calls, demonstrating a commitment to customer satisfaction. * Taking on additional projects and duties as assigned, showcasing adaptability and a willingness to learn. **Qualifications** To succeed in this role, you'll need: * 1 to 3 years of customer service experience, preferably in the healthcare field, with a strong understanding of healthcare terminology and concepts. * Experience in a high-volume call center environment, with a proven track record of meeting quality standards and delivering exceptional customer service. * A background in healthcare or health insurance (BCBS HMOI or other insurance plans experience is a plus), with a deep understanding of healthcare policies and procedures. * Proficiency in Microsoft Office and multiple systems, with the ability to learn new software and technologies quickly. * Excellent verbal and written communication skills, with the ability to articulate complex information in a clear and concise manner. * HMO Managed care Medicare Advantage experience would be highly valued, with a strong understanding of related policies and procedures. **Skills and Competencies** To excel in this role, you'll need to possess: * Strong problem-solving and analytical skills, with the ability to think critically and resolve complex issues. * Excellent communication and interpersonal skills, with the ability to build rapport with clients and colleagues. * A customer-centric approach, with a focus on delivering exceptional service and ensuring customer satisfaction. * Strong organizational and time management skills, with the ability to prioritize tasks and meet deadlines. * A commitment to ongoing learning and professional development, with a willingness to adapt to changing policies and procedures. **Career Growth Opportunities and Learning Benefits** At [Company Name], we're committed to supporting your career growth and development. As a Customer Service Representative, you'll have access to: * Ongoing training and development programs, designed to enhance your skills and knowledge. * Mentorship and coaching, with experienced professionals who can guide and support you. * Opportunities for advancement, with a clear career path and opportunities for promotion. * A collaborative and supportive work environment, with a focus on teamwork and collaboration. **Work Environment and Company Culture** We're proud of our company culture, which prioritizes: * A supportive and inclusive work environment, with a focus on diversity and inclusion. * Flexible work arrangements, including remote work options and flexible hours. * A commitment to work-life balance, with a focus on employee well-being and satisfaction. * Opportunities for socialization and team-building, with regular events and activities. **Compensation, Perks, and Benefits** We offer a comprehensive compensation package, including: * A competitive base pay range of $18.45 to $20.50 per hour, paid bi-weekly per our standard payroll practices. * World-class benefits, including comprehensive medical, dental, and vision plans, long and short-term disability, life insurance, and a 401k plan with a generous match. * Paid time off program, including paid holidays and flexible time, ensuring a healthy work-life balance. **Equal Opportunity Employer** We're an equal opportunity employer, dedicated to fostering a diverse, inclusive, and welcoming environment. We make employment decisions without regard to: * Race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. **Security Responsibilities** This position is responsible for following all Security policies and procedures to protect all Protected Health Information (PHI) under our custodianship, as well as our Intellectual Properties. Security-specific roles may have further defined responsibilities. **Employment Type** This is a full-time position, with a regular schedule and opportunities for advancement. **How to Apply** If you're a motivated and customer-focused individual with a passion for healthcare, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, to [insert contact information]. Apply for this job