Note: The job is a remote job and is open to candidates in USA. Hays is seeking a Customer Service Representative to support customers with insurance and benefits questions across phone and digital channels. The role involves resolving complex inquiries, documenting interactions, using AI-powered tools, escalating issues when needed, and contributing to process improvements while protecting customer information.
Responsibilities
- Serve as the primary point of contact for customers across phone and digital channels, resolving complex policy, coverage, billing, and service inquiries end-to-end with professionalism and care
- Apply established guidelines and approved exception processes to resolve non-routine issues, including complex and sensitive customer situations
- Utilize AI-powered tools that provide guided workflows, suggest next steps, and support summarization of customer interactions to provide accuracy and efficiency in resolving customer needs
- Review and validate AI-generated call summaries and case notes before final submission, exercising judgment to ensure accuracy and alignment with policy, procedure, and customer intent
- Maintain accurate, complete, and timely documentation of customer interactions in accordance with recordkeeping, privacy, and regulatory requirements
- Identify issues requiring escalation and coordinate with internal partners, supervisors, or specialist teams to achieve resolution
- Provide input on recurring issues, knowledge gaps, or process improvement opportunities through established feedback mechanisms
- Participate in required training and ongoing skill development related to products, processes, systems, and AI-enabled tools
Skills
- 1+ years of customer service experience in a customer-facing role (e.g., call center, retail, healthcare, financial services, hospitality, or similar)
- Experience resolving complex customer issues across multiple systems (e.g., CRM platforms, knowledge bases, or customer communication systems)
- Ability to apply judgment in non-routine situations while working within defined guidelines and compliance requirements
- Strong verbal and written communication skills with the ability to interpret and explain information clearly to customers
- High school diploma or equivalent
- 2+ years of experience in insurance, financial services, healthcare, or another regulated industry
- Experience using AI-assisted service tools such as CoPilot, automated summarization, or guided decision workflows
- Experience handling escalations, complaints, or sensitive customer situations
- Familiarity with authentication, data protection, and compliance standards in a regulated environment
Benefits
- Fully remote work arrangement
- Paid training
Company Overview