Healthcare Customer Service Representative

Job Title: Customer Service Representative – Medicare Advantage

Job Description:

We are seeking a dedicated and professional Customer Service Representative to join our Medicare Advantage call center team. The ideal candidate will provide excellent customer service to all Medicare Advantage members, assist with coverage and claims-related questions, and accurately interpret benefits and policy provisions for all products.

This role involves conducting research and follow-up for prompt resolution, working efficiently in a high-volume call center while maintaining a professional and polite manner, and advocating for the customer by explaining benefits in a detailed and courteous way.

Responsibilities:

• Deliver outstanding customer service to Medicare Advantage members.
• Address coverage and claims inquiries with clarity and accuracy.
• Interpret benefits and policy provisions across all products.
• Conduct timely research and follow-up to resolve issues.
• Maintain professionalism in a fast-paced call center environment.
• Investigate and triage customer concerns and dissatisfaction.
• Advocate for customers by clearly explaining their benefits.

Skills and Qualifications:

• Strong background in customer service and support.
• Experience in a call center environment with an understanding of performance metrics.
• Proficiency in Windows and Microsoft Office.
• Excellent phone etiquette and a professional demeanor.
• Effective problem-solving skills and efficiency in issue resolution.
• Empathy and a customer-first mindset are essential.
• Prior experience in healthcare is preferred.

Experience Level:

Intermediate

If you are passionate about helping others and meet the qualifications for this role, we encourage you to apply. Join our team and make a meaningful difference in the lives of Medicare Advantage members.