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Commercial Health Call Center Representative- REMOTE

4 days, 7 hours ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
CRM Salesforce
Apply Now
Evry Health

Evry Health

Evry Health is a modern health insurance company that prioritizes delivering great benefits at affordable prices. They offer a unique approach to health insurance by focusing on making members healthier and happier through personalized care from a dedi...

Insurance
11-50
Founded 2017
$7M raised
View All Jobs 5

Description

  • Research, review, and respond to inquiries from members and providers by phone and email.
  • Handle inbound and outbound calls while delivering a strong customer service experience.
  • Use company policies, benefits information, claims data, and eligibility details to answer inquiries accurately.
  • Manage escalations, member complaints, and complaint appeals with urgency and follow-through.
  • Collaborate with internal departments, vendors, business partners, and providers to resolve issues.
  • Document all calls accurately and maintain established production and quality standards.
  • Identify trends in call types and share suggested solutions with leadership.
  • Help members navigate the member portal and encourage self-service tool adoption.
  • Maintain attendance, schedule adherence, and effective participation in a virtual work environment.
  • Develop or improve processes, call scripts, metrics, and desktop procedures as needed.

Requirements

  • At least 2 years of customer service experience supporting a commercial health plan.
  • Must live and work in the United States, specifically in the CST or EST time zones.
  • Experience supporting business and operational units such as Claims, Medical Management, and Appeals and Grievance.
  • Knowledge of medical and insurance terminology, including CPT, ICD-10, HCPCS, and Revenue Codes.
  • Strong verbal and written communication skills with the ability to explain complex topics clearly.
  • Comfort working in a fast-paced, deadline-oriented environment.
  • Strong attention to detail, problem-solving ability, and a high level of accuracy.
  • Proficiency with Microsoft Office tools such as Word, Excel, Outlook, and OneNote.
  • Prior experience using a CRM, preferably Salesforce.
  • Fluency in Spanish is a plus.

Benefits

  • Competitive salary.
  • Comprehensive health, dental, vision, life, and disability insurance.
  • Retirement savings plan with company match.
  • Generous time off and vacation.
  • Professional development opportunities.
  • Flexible, remote work environment.

Interested in this position?

Apply directly on the company website

Apply Now

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