Customer Service Representative - Remote

Role overview

Handle inbound customer service inquiries from members and providers by phone and email. The representative identifies each caller’s needs, provides accurate information about available programs, documents interactions, and works toward a timely resolution. The role combines routine requests with cases that require judgment, troubleshooting, or coordination with other teams.

Responsibilities

- Assess and prioritize caller questions or concerns, then determine an appropriate resolution. - Investigate problems and explain solutions in line with established procedures. - Maintain or restore caller satisfaction and involve other teams when needed. - Explain program benefits and provide accurate information about services. - Record communications and process information accurately using computer systems. - Track escalated issues and follow up, while meeting call center quality, attendance, and performance expectations.

Requirements

- High school diploma. - Experience in a customer service role is preferred. - Strong communication skills, ability to multitask, and confidence working with callers as part of a team. - Medical records experience and knowledge of the key elements of a valid release-of-information request. - Computer keyboard proficiency, internet navigation skills, and general familiarity with Microsoft Word and Outlook. - Ability to adapt to a fast-changing work environment.

Nice to have

- Familiarity with HIPAA requirements. - Fluency in both Spanish and English.