Medical Claims Customer Service Representative - Remote | WFH

About Us

We are a data-driven, performance-focused healthcare organization committed to operational excellence. Our mission is to make high-quality healthcare affordable, enhance patient health, and renew the satisfaction of practicing medicine for healthcare providers. By integrating empathy with AI and predictive analytics, we use remote Healthguides? and a centralized Managed Service... Organization to foster stronger connections between patients and providers. Our physician-led team empowers our partners to deliver exceptional healthcare, prioritizing outcomes and value for all patients.

Your Role

As a Customer Service Representative, you'll be a key player in our team, ensuring timely and effective responses to client and member calls. Your role involves solving problems, working collaboratively, and meeting quality standards. You'll provide courteous and professional service while handling various tasks and projects, including mailing assistance.

What You'll Do

Handle client and member calls with accuracy and follow-through.

Deliver outstanding customer service.

Address inquiries related to claims payment, status, and coverage information.

Interpret client health plan protocols.

Assist with claims processing tasks, including reports and workflow queues.

Document calls accurately and maintain high professionalism.

Return incoming calls and perform additional duties as assigned.

What You'll Need

1 to 3 years of customer service experience in healthcare.

Knowledge of healthcare claims processing.

Experience in a high-volume call center.

Background in healthcare or health insurance.

Familiarity with BCBS HMOI or other insurance plans is a plus.

Proficiency in Microsoft Office and multiple systems.

Excellent verbal and written communication skills.

Availability for an 8-hour shift between 8 AM and 6 PM Central Time.

What We'd Love

Experience with HMO Managed Care and Medicare Advantage.

Benefits

While you contribute to advancing value-based healthcare, we are committed to supporting you and your family with the following benefits:

Work from Home: Enjoy the flexibility of a fully remote position, reducing commute time and allowing you to focus on your professional and personal goals.

Health Coverage: Comprehensive Medical, Dental, and Vision plans to keep you and your family well-covered.

Retirement Planning: Our 401(k) plan includes a 3% employer match on your 6% contribution.

Peace of Mind: Life and Disability insurance, with optional additional coverage for you and your loved ones.

Support During Tough Times: Access our Employee Assistance Program (EAP) for extra support.

Flexible Time Off: Tailored PTO to help you achieve work-life balance and meet personal goals.

Paid Parental Leave: Time off to support you when welcoming a new family member.

Professional Growth: Resources and opportunities dedicated to your career development.

Compensation

The base pay range for this role is between $18.45 and $20.50 per hour, paid bi-weekly. Final pay rates are based on factors such as skill set, relevant experience, education, location, and certifications.

Equal Opportunity Employment

We are committed to diversity, inclusion, and belonging. We are an equal opportunity employer and make employment decisions without regard to race, religion, color, age, sex, sexual orientation, gender identity, national origin, citizenship, marital status, familial status, disability, military or veteran status, pregnancy, or any other protected status. We ensure fair treatment in all aspects of employment.

Security Policies

This role involves adhering to all security policies and procedures to protect all PHI and intellectual properties. Specific responsibilities for security-related roles will be defined by the hiring manager.

Employment Type: Full-Time