RemoteLeaf Logo
Log in Sign up

Commercial Health Call Center Representative- REMOTE

1 week, 5 days 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 6

Description

  • Research, review, and respond to inquiries from members and providers.
  • Use active listening, patience, empathy, and tact to handle difficult calls professionally.
  • Manage escalations within the department and follow issues through to closure.
  • Apply company policies, procedures, benefits, claims, and eligibility information to answer inquiries accurately.
  • Handle member complaints and complaint appeals.
  • Coordinate problem solving with internal departments, vendors, business partners, and providers.
  • Interpret claims and claim payment questions using basic billing guideline knowledge.
  • Document all calls accurately and recognize trends or patterns in call types.
  • Meet production, quality, attendance, and schedule adherence standards.
  • Support members using the member portal and encourage self-sufficiency with company tools.

Requirements

  • Minimum of 2 years of customer service experience supporting a commercial health plan.
  • Experience collaborating with 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.
  • Excellent verbal and written communication skills with the ability to explain complex topics to a broad audience.
  • Ability to work in a fast-paced, deadline-oriented environment.
  • Strong attention to detail, problem-solving skills, and a high level of accuracy.
  • Proficiency with Microsoft Office applications including Word, Excel, Outlook, and OneNote.
  • Prior CRM experience, preferably Salesforce.
  • Must be based in the United States and reside in the CST or EST time zones.
  • Must have a dedicated private work area, secure handling for sensitive documents, and high-speed internet access.
  • Fluency in Spanish is preferred.

Benefits

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

Interested in this position?

Apply directly on the company website

Apply Now

Similar Roles

Mercier Consultancy

Dutch Speaking Customer Support Specialist - Work In Sofia - Paid Relocation

Mercier Consultancy Professional Services

Mercier Consultancy MD is hiring a Dutch Speaking Customer Support Specialist in Sofia, Bulgaria to support Dutch-speaking clients and strengthen customer relationships in an international setting.

Bulgaria Greece Latvia Malta Poland Portugal Full-time Junior Customer Support
1 hour, 47 minutes ago
Pavago

Medical Customer Service Representative

Pavago IT Services

A remote, full-time Medical Customer Service Representative at a healthcare support operation will assist patients across communication channels with scheduling, billing, and service inquiries during U.S. business hours.

Mexico Brazil Colombia Full-time Junior Customer Support
CRM HIPAA
1 hour, 50 minutes ago
Mercier Consultancy

German Speaking Player Support Specialist for Riot Games Account - Work In Sofia

Mercier Consultancy Professional Services

Mercier Consultancy MD is hiring a German Speaking Player Support Specialist in Sofia, Bulgaria to provide support for Riot Games account holders and help ensure a smooth player experience.

Bulgaria Full-time Junior Customer Support
2 hours, 29 minutes ago
AlphaSense

Analyst, Customer & Product Support

AlphaSense 251-1K Internet Software & Services

AlphaSense is hiring an Analyst, Customer & Product Support to serve as the first line of support for customers using its AI-driven market intelligence platform and to help improve customer outcomes across the business.

India Full-time Junior Customer Support Product Analyst
2 hours, 35 minutes ago

You're on a roll! Sign up now to keep applying.

Sign Up

Already have an account? Log in

Used by 14,729+ remote workers