Experienced Customer Service Representative – Health Insurance and Managed Care
Are you passionate about delivering exceptional customer experiences and making a meaningful impact in the lives of others? Do you thrive in a dynamic and fast-paced environment where no two interactions are ever the same? If so, we invite you to join our team at careerzynith as a Customer Service Representative – Health Insurance and Managed Care. As a key member of our customer service team, you will play a vital role in providing top-notch support to our valued customers, fostering a sense of job satisfaction through problem-solving and positive interactions.
**About careerzynith**
careerzynith is a leading healthcare solutions provider that partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Our mission is to connect the pieces of the fragmented healthcare system and ensure that people receive the same level of care and compassion that we would want for our loved ones. At careerzynith, we believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's why diversity and inclusion are core to our business.
**What You'll Be Doing**
As a Customer Service Representative – Health Insurance and Managed Care, you will be responsible for providing exceptional support to our valued customers, fostering a sense of job satisfaction through problem-solving and positive interactions. Your key responsibilities will include:
* Answering and managing inbound inquiries regarding health plan benefits and claims, eligibility, medical and other healthcare procedures, billing and payments, and other related topics from customers in a prompt, courteous manner.
* Conducting out-bound and/or return calls to customers as necessary.
* Asking appropriate questions and listening actively to identify specific questions or issues to provide appropriate response and type of assistance the customer needs while documenting relevant information in a clear and concise manner in computer systems.
* Communicating and partnering with customers tactfully and empathetically to resolve issues, using clear language to translate healthcare-related jargon and complex processes into simple, step-by-step instructions that customers can comprehend and act upon.
* Handling and processing customer complaints/grievances while applying appropriate conflict management skills to de-escalate potentially stressful situations.
* Meeting the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction, and attendance.
* Adhering to all applicable department, organization, and/or regulatory policies and procedures.
**What You Bring**
To be successful in this role, you will need to bring the following skills and qualifications:
* Bilingual in Spanish and English (validated via bilingual assessment upon offer acceptance) is a plus.
* At least 1 year of call center experience is required.
* Ability to handle a heavy call volume of 50-100 calls daily.
* Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills, ability to type 35 WPM, and learn new computer programs.
* Ability to work regularly scheduled shifts within hours of operation, including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule and work overtime and/or weekends as needed.
* Demonstrated ability to take an educative approach, listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the customer, answering questions and informing of health plan policies, procedures, or decisions.
* Ability to maintain strict confidentiality of protected health information.
* This is a work-from-home position, which requires a quiet, private workspace without noise and distractions, and reliable internet connectivity provided through a wired connection with a minimum of 100 MBPS speed.
* 2+ years of experience at a health plan, TPA, or related call center setting is a plus.
* Knowledge of managed care, Commercial, Marketplace, Medicaid, and/or Medicare programs; knowledge of medical policy benefits and exclusions is a plus.
**Technical Requirements**
We require that all employees have the following technical capability at their home:
* High-speed internet over 10 Mbps
* The ability to plug in directly to the home internet router
**What We Offer**
As a valued member of our team, you will enjoy a competitive salary, a bonus component that is dependent on pre-defined performance factors, and comprehensive benefits (including health insurance benefits) to qualifying employees. Our total compensation package is designed to recognize and reward your skills and experience, and may vary above and below the stated amounts.
**Why Join careerzynith?**
At careerzynith, we value a great attitude and a willingness to learn above all. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's why diversity and inclusion are core to our business. We offer a dynamic and fast-paced work environment where you will have the opportunity to make a meaningful impact in the lives of others.
**Don't Hesitate, Apply!**
Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today and join our team at careerzynith as a Customer Service Representative – Health Insurance and Managed Care.
Apply To This Job
**Equal Opportunity Employer**
careerzynith is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact [email protected] for further assistance.
**Don't See the Dream Job You're Looking For?**
Drop off your contact information and resume, and we will reach out to you if we find the perfect fit!
Apply for this job
**About careerzynith**
careerzynith is a leading healthcare solutions provider that partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions. Our mission is to connect the pieces of the fragmented healthcare system and ensure that people receive the same level of care and compassion that we would want for our loved ones. At careerzynith, we believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's why diversity and inclusion are core to our business.
**What You'll Be Doing**
As a Customer Service Representative – Health Insurance and Managed Care, you will be responsible for providing exceptional support to our valued customers, fostering a sense of job satisfaction through problem-solving and positive interactions. Your key responsibilities will include:
* Answering and managing inbound inquiries regarding health plan benefits and claims, eligibility, medical and other healthcare procedures, billing and payments, and other related topics from customers in a prompt, courteous manner.
* Conducting out-bound and/or return calls to customers as necessary.
* Asking appropriate questions and listening actively to identify specific questions or issues to provide appropriate response and type of assistance the customer needs while documenting relevant information in a clear and concise manner in computer systems.
* Communicating and partnering with customers tactfully and empathetically to resolve issues, using clear language to translate healthcare-related jargon and complex processes into simple, step-by-step instructions that customers can comprehend and act upon.
* Handling and processing customer complaints/grievances while applying appropriate conflict management skills to de-escalate potentially stressful situations.
* Meeting the performance goals established for the position in the areas of efficiency, accuracy, quality, member satisfaction, and attendance.
* Adhering to all applicable department, organization, and/or regulatory policies and procedures.
**What You Bring**
To be successful in this role, you will need to bring the following skills and qualifications:
* Bilingual in Spanish and English (validated via bilingual assessment upon offer acceptance) is a plus.
* At least 1 year of call center experience is required.
* Ability to handle a heavy call volume of 50-100 calls daily.
* Demonstrated ability in using computer and Windows PC applications, which includes strong keyboard and navigation skills, ability to type 35 WPM, and learn new computer programs.
* Ability to work regularly scheduled shifts within hours of operation, including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule and work overtime and/or weekends as needed.
* Demonstrated ability to take an educative approach, listen skillfully, collect relevant information, determine immediate requests, and identify the current and future needs of the customer, answering questions and informing of health plan policies, procedures, or decisions.
* Ability to maintain strict confidentiality of protected health information.
* This is a work-from-home position, which requires a quiet, private workspace without noise and distractions, and reliable internet connectivity provided through a wired connection with a minimum of 100 MBPS speed.
* 2+ years of experience at a health plan, TPA, or related call center setting is a plus.
* Knowledge of managed care, Commercial, Marketplace, Medicaid, and/or Medicare programs; knowledge of medical policy benefits and exclusions is a plus.
**Technical Requirements**
We require that all employees have the following technical capability at their home:
* High-speed internet over 10 Mbps
* The ability to plug in directly to the home internet router
**What We Offer**
As a valued member of our team, you will enjoy a competitive salary, a bonus component that is dependent on pre-defined performance factors, and comprehensive benefits (including health insurance benefits) to qualifying employees. Our total compensation package is designed to recognize and reward your skills and experience, and may vary above and below the stated amounts.
**Why Join careerzynith?**
At careerzynith, we value a great attitude and a willingness to learn above all. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's why diversity and inclusion are core to our business. We offer a dynamic and fast-paced work environment where you will have the opportunity to make a meaningful impact in the lives of others.
**Don't Hesitate, Apply!**
Don't worry if you don't meet every single requirement. We value a great attitude and a willingness to learn above all. Submit your application today and join our team at careerzynith as a Customer Service Representative – Health Insurance and Managed Care.
Apply To This Job
**Equal Opportunity Employer**
careerzynith is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact [email protected] for further assistance.
**Don't See the Dream Job You're Looking For?**
Drop off your contact information and resume, and we will reach out to you if we find the perfect fit!
Apply for this job