Customer Service Representative - Remote Eligible

Customer Service Representative

The Customer Service Representative provides essential support to members and providers by managing inbound calls regarding claims, eligibility, and benefit inquiries. This role requires strong communication skills, empathy, and adaptability to deliver a high-quality experience in a fast-paced environment. The position is key to ensuring positive member interactions, efficient issue resolution, and maintaining the organization's reputation for service excellence.

Key Responsibilities:

• Receive inbound calls from members and providers regarding claims status, eligibility, and benefit information.
• Navigate multiple systems efficiently; training provided on the Avaya phone system.
• Maintain professionalism and empathy throughout all customer interactions.
• Adapt quickly to process updates and system changes in a dynamic, high-volume environment.
• Ensure punctuality and consistent attendance, particularly during the training period.
• Participate in on-camera training and adhere to Work-from-Home policies.

Minimum Education & Experience Requirements:

• High School Diploma or GED required.
• Customer service experience required.
• Call center experience preferred; health insurance call center experience highly desirable.

Special Requirements:

• Must maintain excellent attendance, particularly during the first three months of employment.
• Professional demeanor and adherence to virtual training expectations are required.

Knowledge, Skills, and Abilities:

• Strong communication and active listening skills.
• Demonstrated empathy and professionalism in customer interactions.
• Ability to manage and control conversations effectively.
• Proficient computer and data entry skills; ability to learn new systems quickly.
• Capable of multitasking and maintaining composure in a fast-paced setting.
• Bilingual (Spanish/English) proficiency is highly beneficial.

Additional Desired Characteristics:

• Positive attitude, adaptability, and commitment to team success.
• Strong problem-solving and critical-thinking abilities.
• Self-motivated with a strong sense of accountability and reliability.

Other Duties:

• This job description is not intended to be all-inclusive. The employee may perform other related duties as assigned to meet the ongoing needs of the organization.