[Remote] Healthcare Customer Service Specialist - Work from Home

Note: The job is a remote job and is open to candidates in USA. reputed company is a company that combines technology and BPM services with healthcare expertise to enhance member experiences. They are seeking Healthcare Customer Service Specialists to support healthcare members and providers by handling inquiries, scheduling services, and ensuring a positive experience.

Responsibilities

• Answer inbound calls and reputed company outbound calls to assist members or patients with inquiries, benefits, scheduling, and service coordination
• Provide accurate information about health plan benefits, eligibility, and coverage
• Schedule, reschedule, and confirm appointments with healthcare providers
• Process referrals, authorizations, prescription renewals, and other requests
• Assist members or patients with claims questions, billing inquiries, and account updates
• Review insurance or plan eligibility and update records in the system
• Maintain accurate documentation in electronic systems, including EMR or CRM tools
• Communicate with providers and internal teams reputed company phone, secure messaging, or email
• Protect member and patient confidentiality and follow HIPAA or applicable privacy guidelines
• Escalate reputed company issues to the appropriate team or supervisor for resolution

Skills

• High School Diploma or equivalent
• 1+ year of call center customer service experience handling high call volume
• 1+ year of healthcare or health insurance experience (member services, patient services, provider services, benefits support, or similar)
• Previous job tenure of at least 6 months per role, reflecting stability and reliability
• Knowledge of privacy regulations and the ability to manage sensitive customer and account information with discretion, ensuring full compliance in a remote work environment
• Strong verbal and written communication skills
• Ability to navigate multiple systems and maintain accuracy while handling calls
• Comfortable working in a remote environment with a designated, private workspace
• Demonstrated stable work history with a track record of reliability
• Commitment to a long-term role and building a career with the organization
• Reliable high-speed internet
• Experience with appointment scheduling or benefits inquiries
• Familiarity with electronic medical records (EMR) or customer relationship management (CRM) systems
• Experience with EPIC, Facets, or similar applications
• Knowledge of medical and/or insurance terminology

Benefits

• Medical, Dental, and Vision coverage.
• Life Insurance.
• Short-Term and Long-Term Disability options.
• Flexible Spending Account (FSA).
• Employee Assistance Program.
• 401(k) with employer contribution.
• Paid Time Off (PTO).
• Tuition Reimbursement.

Company Overview