Remote Customer Service Representative (CSR) - Health Plan Call Center

Location: 100% Remote (Preference for candidates in PST) Schedule... • Training: Monday - Friday, 8:00 AM - 4:30 PM CST for 4-6 weeks • Regular Schedule: Shifts vary between 11:00 AM - 9:00 PM EST, Monday - Friday • Important Note: 100% attendance is required during training. Any significant time missed may result in termination of your contract. • Start Date: 10/7/2024 Job Description: We are seeking dedicated and empathetic Customer Service Representatives (CSRs) to join our health plan call center team. This is a fully remote position with a preference for individuals who can work later shifts, making it ideal for candidates located in the PST time zone. As a CSR, you will provide support to health plan members, providers, and their representatives by managing inbound inquiries and conducting outbound calls when necessary. This role involves addressing questions related to health plan benefits, claims, eligibility, billing, and more. You will be expected to handle 50-100 calls daily, with a focus on providing clear, concise, and compassionate assistance. Key Responsibilities: • Answer and manage inbound inquiries about health plan benefits, claims, eligibility, and related topics. • Conduct outbound or return calls as needed. • Document relevant information clearly and concisely in computer systems. • Communicate complex healthcare-related information in simple, understandable terms. • Handle customer complaints and grievances with empathy and effective conflict management skills. • Meet performance goals related to efficiency, accuracy, quality, member satisfaction, and attendance. • Adhere to all applicable department, organization, and regulatory policies and procedures. Requirements: • High school diploma or GED. • Minimum of 1 year of call center experience. • Ability to handle 50-100 calls daily. • Proficiency with computers and Microsoft applications, including strong keyboard and navigation skills. • Ability to type at least 35 WPM. • Availability to work scheduled shifts and overtime as needed. • Ability to maintain confidentiality of protected health information (HIPAA compliance). Preferred Qualifications: • 2+ years of experience in a health plan, TPA, or related call center. • Knowledge of managed care, Commercial, Marketplace, Medicaid, and/or Medicare programs. • Bilingual in Spanish & English (validated via bilingual assessment upon offer acceptance). At Home Workspace Requirements: • A quiet, private workspace free from noise and distractions. • Dedicated workspace within your home, outside of common areas. • Resolved dependent and/or pet care arrangements during working hours. • Workspace must ensure privacy and confidentiality of HIPAA/PHI information. • Working from public places or outside the country is not permitted. Technology Requirements: • Smartphone for accessing Microsoft Multi-Factor Authentication & Microsoft Teams. • High-speed internet service (100 MBPS fiber optic) with direct router connection via Ethernet cord. • Incompatible internet services: 4G, 5G, LTE, or Satellite. Company-Supplied Equipment: • Dell Laptop/Small PC (depending on inventory). • Power cords, one large monitor, keyboard, mouse, headset, and 15-foot Ethernet cable Apply Job!