Customer Service Representative II
New
USFull-TimeMiddle
Salary38,500 - 57,800 USD per year
Apply NowOpens the employer's application page
Job Details
- Experience
- 2 years
- Required Skills
- Customer serviceMicrosoft Office Suite
Requirements
- High School Diploma or GED required.
- Minimum of 2 years of customer service experience in a related field.
- Experience in high-volume call center environments with inbound and outbound interactions.
- Strong ability to de-escalate customer concerns with empathy, professionalism, and clear communication.
- Proficiency in Microsoft Office Suite or similar tools, with the ability to navigate multiple systems simultaneously.
- Ability to adapt communication style for diverse audiences, including members and healthcare professionals.
- Strong attention to detail and ability to work with sensitive and confidential information.
- Experience in healthcare, insurance, or claims processing environments is highly valued.
- Ability to accept feedback and adjust performance in a structured, metrics-driven environment.
- Strong organizational skills with the ability to manage multiple tasks and shifting priorities.
Responsibilities
- Handle inbound and outbound customer service interactions, ensuring first-call resolution and providing accurate information regarding claims, benefits, and coverage.
- Research and resolve member and provider inquiries, escalating complex issues to appropriate departments when necessary.
- Document all customer interactions thoroughly and maintain accurate records in compliance with internal and regulatory standards.
- Follow up on pending requests and ensure timely resolution of outstanding items across systems and workflows.
- Communicate clearly and professionally with members, healthcare providers, and external vendors across multiple regions.
- Maintain strict adherence to confidentiality requirements, including handling of Personal Protected Information (PPI) and HIPAA regulations.
- Support continuous improvement of service quality by meeting performance metrics and adapting to evolving processes and feedback.
View Full Description & ApplyYou'll be redirected to the employer's site
