We are hiring a Call Center Member & Provider Representative to support both members and healthcare providers with questions regarding eligibility, benefits, and services. This is a customer-focused position where you'll spend your day assisting callers, researching account information, documenting interactions, and connecting customers with the appropriate resources.
The ideal candidate is comfortable working in a busy call center, can navigate multiple computer systems, and has strong communication and problem-solving skills.
Responsibilities
- Manage incoming calls from members and healthcare providers and provide professional, helpful assistance.
- Answer questions regarding eligibility, benefits, coverage, and related services.
- Review customer and provider information to research questions and determine appropriate solutions.
- Accurately document conversations, requests, and resolutions in a CRM or ticketing system.
- Maintain detailed customer records and update information following each interaction.
- Work with internal teams and management to address questions or customer service concerns.
- Escalate or transfer calls when an issue requires additional support.
- Respond to written inquiries and assist with follow-up requests.
- Make outbound calls to members when follow-up is needed, including responding to voicemail messages.
- Follow established procedures, service standards, and productivity expectations.
- Maintain professionalism and confidentiality when handling customer information.
Qualifications
- High school diploma or GED required.
- At least 6 months of customer service or telephone-based experience; 1+ year preferred.
- Previous call center, healthcare, insurance, member services, or provider services experience is a plus.
- Comfortable using computers, telephone systems, fax machines, and other office technology.
- Experience with CRM, help desk, ticketing, or customer service software preferred.
- Strong written and verbal communication skills.
- Excellent organization, attention to detail, and follow-through.
- Ability to research information and use sound judgment when resolving customer questions.
- Comfortable working independently and following established procedures and instructions.
Technology Requirements
Candidates should be comfortable working with multiple applications and navigating computer systems while assisting customers. Experience with:
- Microsoft Word
- Microsoft Outlook
- Microsoft Teams
- Internet browsers
- CRM/ticketing or help desk systems
- Telephone and call center technology
Work Schedule & Location
Training will be provided remotely. After training is completed, employees must be prepared to work on-site if required.
Ideal Candidate
We're looking for someone who is professional, dependable, patient, and solutions-oriented. If you enjoy helping people, communicating with customers, and working in a fast-paced environment, this could be a great opportunity to grow your customer service experience.
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