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Call Center Customer Service Representative - Healthcare - Eligibility & Claims

Remote, USA Full-time Posted 2025-04-16

Job description

Healthcare Customer Service Representative

Transparent Health Group is a rapidly growing healthcare benefit services company that provides the services and technology necessary to make complex health plans work for its members. We ensure employers and their employees have the information they need to make informed decisions about their healthcare benefits. Our goal is to eliminate surprises in our members' healthcare coverage!

The Call Center Representative answers phones promptly and professionally and is responsible for providing eligibility, benefits, and claim status. The ideal candidate has strong customer service and communication skills with the ability to work efficiently in a fast-paced environment.

Position Overview
?? Abide by all HIPAA requirements
?? Heavy Inbound Call Volume - Providers
?? Confirm Benefits and Eligibility
?? Ability to read and understand Benefit Overviews
?? Respond to Claim Inquiries via phone and email
?? Familiar with reading Explanation of Benefits (EOBs)
?? Meet and Adhere to all KPI metrics
?? Ability to complete daily tasks in between calls
?? Adhere to policies and procedures

Why Work with Us
?? 100% remote, work-from-home position
?? Benefits are available on day 1 of employment which include medical, vision, and dental
?? In-depth training program to guarantee success in your position
?? Fast-growing company
?? Opportunities for advancement
?? Supportive team-based workplace
?? 3 weeks of PTO plus 8 paid company holidays
?? Monday-Friday position, no weekends!
?? Our family values mean we are committed to a real living wage, with meaningful benefits

Requirements
?? Experience working in health insurance
?? Must possess a high level of organization, reliability, and attention to detail
?? Phone-based customer service call center experience (High call volume)
?? Comfortable working with technology
?? Exceptional verbal and written communication skills
?? Outstanding track record of attendance and adherence to schedule
?? Proper utilization of resources
?? Accept feedback in a positive manner
?? Quiet and private home working environment, where you can work uninterrupted for the duration of your shift
?? Self-starter who demonstrates working independently
?? Reliable high-speed Internet access required
?? Successful multitasker who can ensure all responsibilities are completed on time

Personal Attributes Needed for Success
?? Ability to build rapport with a wide range of people
?? Excellent follow-up and follow-through skills
?? Strong desire to be of service and assist others
?? Motivated by being in a supportive role and contributing to team success
?? Bilingual a plus! English and Spanish, English and Chinese, English and Mandarin, English and Russian
?? Familiarity with Indemnity Plans a PLUS!

Job Type: Full-time

Pay: $17.00 - $19.00 per hour

Benefits:
?? 401(k)
?? 401(k) matching
?? Dental insurance
?? Health insurance
?? Life insurance
?? Paid time off
?? Referral program

Schedule:
?? 8 hour shift
?? Day shift
?? Monday to Friday

Application Question(s):
?? Do you have any familiarity with Indemnity Plan?

Experience:
?? Call Center/Heavy Phone: 1 year (Required)
?? Medical Insurance: 1 year (Required)
?? Customer Service: 1 year (Required)

Work Location: Remote

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