• We are seeking a dedicated and compassionate Customer Service Representative to join our healthcare account team. In this role, you will be the primary point of contact for patients, members, and healthcare providers, delivering outstanding service while addressing inquiries related to health insurance coverage, benefits, claims, and other healthcare-related services.

Key Responsibilities:

• Answer inbound calls, emails, and chat inquiries from patients, members, and healthcare providers.
• Provide accurate information regarding healthcare plans, coverage details, claim statuses, and billing concerns.
• Assist with processing prior authorizations, referrals, and appointment scheduling as needed.
• Update and verify patient/member information in healthcare management systems.
• Resolve issues efficiently, ensuring customer satisfaction while maintaining compliance with healthcare regulations.
• Educate customers on available healthcare services, preventive care options, and claim processes.
• Document all interactions and maintain accurate customer records.
• Uphold patient confidentiality and comply with HIPAA and other healthcare regulations.

Qualifications:

• High school diploma or equivalent; college education is a plus.
• Prior customer service experience, preferably in a healthcare or insurance environment.
• Strong verbal and written communication skills.
• Ability to demonstrate empathy, patience, and professionalism in sensitive situations.
• Proficient in using computer systems, CRM tools, and healthcare databases.
• Knowledge of medical terminology and insurance processes is an advantage.
• Ability to multitask and work effectively in a fast-paced, team-oriented environment.