Customer Service Representative

Job Description

Job Description

We are looking for a dedicated and detail-oriented Customer Service Representative to join our remote team in Troy, Michigan. In this role, you will provide exceptional service to customers by addressing inquiries, resolving issues, and ensuring a seamless experience with healthcare-related matters. This is a Contract-to-Permanent position where you will have the opportunity to grow within the organization based on your performance. If you live in Michigan there is a 1 day per month obligation for in-office.

Responsibilities :

• Respond to customer inquiries regarding medical benefits, claim statuses, and pre-authorizations in a prompt and courteous manner.
• Utilize internal systems to track and document customer interactions and resolutions.
• Stay informed about updates to healthcare plans and communicate changes effectively to customers.
• Provide accurate information to customers about healthcare provider networks and outstanding payments.
• Troubleshoot and resolve issues efficiently while maintaining a detail-oriented demeanor.
• Follow up on unresolved customer concerns to ensure complete satisfaction.
• Escalate complex issues to management when necessary for further resolution.
• Adhere to company policies, including HIPAA regulations, to maintain confidentiality and compliance.
• Occasionally work on-site as required while primarily operating in a remote capacity.
• Collaborate with team members to meet service targets and improve processes.
• Strong background in call center environments, especially with high-volume healthcare-related inquiries.
• Familiarity with medical terminology, diagnosis codes, and healthcare processes is required.
• Excellent verbal and written communication skills to handle sensitive customer interactions.
• Proficiency in Microsoft Outlook and other computer systems, with above-average typing speed.
• Ability to remain calm under pressure and handle challenging situations with professionalism.
• Strong attention to detail and critical thinking skills for accurate issue resolution.
• Availability to work flexible shifts, including evenings, weekends, and holidays.
• Associate’s Degree preferred; alternatively, 1-3 years of healthcare customer service experience in a call center setting.