Note: The job is a remote job and is open to candidates in USA. The client operates in the healthcare industry and is seeking a Customer Service Advocate to support members and providers. The role handles inquiries, resolves basic concerns, documents communications in CRM systems, and ensures compliance with quality and performance standards in a remote contact center environment.
Responsibilities
- Receives and responds to routine member and/or provider inquiries, requests and/or concerns in an accurate and timely manner
- Mitigates and prevents complaints from being escalated to resolve in initial contact
- Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
- Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
- Maintains performance and quality standards based on established contact center metrics
- Provides customer service in a high pace contact center environment over the phone, via live chats and emails
- Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
- Remains up-to-date and adheres to quality standards, regulation, and all other policies to ensure quality, consistency, and compliance
- Performs other duties as assigned
- Complies with all policies and standards
- The main function of a call center/customer service representative is to interact with customers to provide information in response to inquiries about products and services and to handle and resolve customer concerns
- A typical customer service representative is responsible for determining the client’s issue, offer possible solutions or providing follow-up as needed
- Typical customer questions include confirming member eligibility/benefits and checking on the status of claims/authorizations
Skills
- * **Work Location:** Remote – preferred candidates from AZ but can be anywhere as long as they work PST time zone
- * **Must have skills:** **Customer Service / Call Center Experience**
- * **Strong Communication & Active Listening Skills**
- * **Computer Skills & Multitasking – ability to work with multiple systems simultaneously**
- * **Healthcare/Insurance Knowledge – claims, eligibility, benefits, and authorizations**
- * **Education/Certification**: **Required: High School**
- * **Disqualifiers:** Those that have need for time off in the first 6 months
- * Preferred: Some College
Benefits
- Health insurance (medical, dental, vision)
- 401(k) plan
- Paid sick leave (depending on work location)
- Remote work
Company Overview
Company H1B Sponsorship