Senior Customer Service Representative

Role overview

Respond to routine service questions from health plan members and providers by phone, online, or in writing. Help clarify claims status, benefits, eligibility, and provider network participation while meeting established service and performance expectations. The role is described as permanent work from home, with full-time hours.

Responsibilities

- Handle incoming calls and other inquiries from members and providers about claims, coverage, eligibility, and PPO participation. - Research questions and explain available information clearly, escalating or resolving issues as appropriate. - Meet department performance measures while delivering consistent, disciplined service. - Address service challenges and work toward practical solutions to customer needs. - Collaborate with teammates and across groups to support a reliable customer experience.

Requirements

- At least 1 year of customer service experience. - Experience working in an environment measured against performance metrics. - Proficiency with Microsoft applications and comfort using search engines to find information. - Strong communication and multitasking skills. - High school diploma, GED, or equivalent experience.

Nice to have

- Call center experience, familiarity with medical terminology or health insurance, and experience working remotely. - Self-motivation and a results-oriented approach.

Benefits and work setup

Permanent work-from-home role, full time at 40 hours per week. The listing describes eligibility for medical, dental, and vision coverage, paid time off, retirement savings, and wellness programs, subject to plan terms.