Job Description

As a Healthcare Customer Service Representative (CSR), you will be the first point of contact for members, patients, and healthcare providers. You will assist with inquiries related to health insurance plans, benefits, claims, eligibility, billing, and provider information while delivering excellent customer service through phone, email, or chat.

Key Responsibilities

Handle inbound and outbound customer calls in a professional and courteous manner.
Assist members with questions regarding healthcare benefits, coverage, eligibility, claims, and billing.
Provide accurate information about healthcare plans, providers, and medical services.
Resolve customer concerns by researching issues and offering appropriate solutions.
Document customer interactions accurately in the system.
Maintain confidentiality of patient and member information in compliance with HIPAA and company policies.
Meet quality, productivity, attendance, and customer satisfaction targets.
Escalate complex concerns to the appropriate department when necessary.

Qualifications

College graduates are an advantage but not required.
Excellent English communication skills, both verbal and written.
Strong problem-solving and customer service skills.
Basic computer navigation and typing skills.
Willing to work on shifting schedules, weekends, and holidays.
Previous BPO or healthcare customer service experience is an advantage but not required for entry-level roles.

Preferred Skills

Strong attention to detail and active listening skills.
Ability to multitask and work in a fast-paced environment.
Empathy and professionalism when handling customer concerns.
Knowledge of healthcare terminology, insurance, or medical claims is a plus.

This role is ideal for individuals who enjoy helping others, have strong communication skills, and are committed to providing exceptional support in the healthcare industry.

Customer Service Representatives