CUSTOMER CARE REPRESENTATIVE

We are hiring!

Position: Customer Care Representative

We are looking for a Customer Service Representative who will provide professional and efficient support to members, providers, and clients. This role involves assisting with client inquiries, dispute processing, and account troubleshooting, while ensuring excellent service through phone, email, and online communication.

Key Responsibilities

1. Member & Client Support

• Provide prompt and courteous support to members, providers, and client administrators regarding health, dental, vision, and prescription benefits.
• Assist members with enrollments, claims inquiries, coverage details, and account issues.
• Respond to incoming calls and emails, ensuring timely and accurate information.
• Escalate complex issues to the appropriate department when necessary.

2. Claims & Benefits Assistance

• Review and verify customer claims using internal systems.
• Educate members on company services, eligibility requirements, and benefit utilization.
• Assist in processing relevant documentation and resolving disputes.

3. Communication & Collaboration

• Utilize inbound phone systems and Outlook for professional and effective communication.
• Work closely with internal teams to coordinate resolutions for member and provider concerns.
• Maintain accurate records and documentation in compliance with company policies and industry regulations.

4. System Navigation & Reporting

• Access and update member information through company software.
• Generate reports to support customer request verification and member assistance.
• Track and manage service requests using task management software.

5. Training & Continuous Improvement

• Participate in ongoing training to stay up to date with company services, policies, and system updates.
• Identify areas for process improvement and contribute ideas to enhance the customer experience.

Qualifications & Skills

✅ Experience in customer service, call centers, or benefits administration is preferred.

✅ Strong communication skills (both verbal and written) with a customer-first mindset.

✅ Ability to navigate multiple systems, including CRM platforms, claims processing tools, and member portals.

✅ High attention to detail and problem-solving skills to assist members effectively.

✅ Comfortable handling a high volume of calls and emails in a fast-paced environment.

✅ Bilingual (English & Spanish) preferred, but not required.

Why join our team?

🌟 Competitive salary and benefits package

🌟 Opportunity to work in a growing and mission-driven company

🌟 Supportive team environment with ongoing training and career development

If this sounds like you’d be a great fit, apply TODAY!