Call Center Representative

A company is looking for a Call Center Representative to join their Health Plan Services team.

Key Responsibilities

Provide professional and timely support to members and providers regarding plan benefits, eligibility, and claims

Research and resolve complex inquiries and issues with accuracy and empathy

Document and track appeals and grievances while identifying process improvements

Required Qualifications

High School Diploma or GED required

1-3 years of experience in a health plan or customer service setting (Managed Care experience preferred)

Proficiency in Microsoft Office; familiarity with systems like QNXT or MMIS is a plus

Understanding of healthcare administration, including Medicaid and Medicare