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REMOTE (CST/EST): Commercial Health Call Center Representative

1 month ago
United States
Full-time
Junior
Customer Support
Customer and Technical Support
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 2

Description

  • Research, review, and respond to inquiries from members and providers via inbound/outbound calls and email.
  • Provide accurate information on commercial health plan benefits, eligibility, claims, and billing using company policies and procedures.
  • Handle member complaints, complaint appeals, and escalations with appropriate accountability, urgency, communication, and follow-through to closure.
  • Collaborate with internal departments, vendors, business partners, and providers to coordinate timely problem solving.
  • Accurately document all calls and interactions in the required systems or CRM.
  • Recognize trends and patterns in call types and engage leadership with suggested solutions and process improvements.
  • Meet and maintain established department production and quality standards and adhere to attendance and schedule expectations.
  • Assist members with navigating the member portal and encourage self-sufficiency with tools.
  • Actively participate in virtual team huddles, supervisor 1:1s, instant messaging, and other remote check-ins.

Requirements

  • Minimum of 2 years of customer service experience supporting a commercial health plan (not just Medicare, Medicaid, or Pharmacy).
  • Must reside and work in the United States within the CST or EST time zone and be available for company business hours (weekdays 9–5 CST).
  • Experience collaborating with operational units such as Claims, Medical Management, and Appeals and Grievance.
  • Knowledge of medical and insurance industry terminology, including CPT/ICD-10, HCPCS, and Revenue Codes.
  • Excellent verbal and written communication skills with the ability to articulate complex topics to a broad audience.
  • Strong attention to detail, problem-solving skills, and ability to work in a fast-paced, deadline-oriented environment.
  • Proficiency in Microsoft Office applications (Word, Excel, Outlook, OneNote).
  • Prior experience using a CRM, preferably Salesforce.
  • Ability to work remotely with a dedicated, private work area, secure handling of sensitive documents, and reliable high-speed internet connection.
  • Bonus: fluency in Spanish.

Benefits

  • Competitive salary
  • Comprehensive health, dental, and vision insurance plus life and disability coverage
  • 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

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