Call Center Representative

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Lakeshore Talent is partnering with a leading Healthcare organization to hire a Call Center Representative to join their Health Plan Services team. This is a fantastic opportunity for someone with prior experience in healthcare or customer service who enjoys problem-solving, providing exceptional service, and working in a fast-paced environment.

Location : Remote (must be located close enough to Denver, CO to pick up equipment on December 1st)

Schedule : Monday – Friday, 9 : 00 AM – 5 : 30 PM

Contract Length : 8 weeks to start, with the potential for extension through March

Training Begins : December 2nd

Pay Range : $20-$23 / hr

About the Role

In this role, you’ll support the day-to-day operations of a Managed Care Health Plan. You’ll work directly with members and providers to resolve issues related to benefits, eligibility, claims, and authorizations. This position requires strong communication skills, attention to detail, and the ability to think critically to solve problems.

You’ll collaborate with internal departments, community organizations, and state entities—making a direct impact on ensuring members receive the support and services they need.

Key Responsibilities

Provide professional and timely support to members and providers regarding plan benefits, eligibility, and claims

Research and resolve complex inquiries and issues with accuracy and empathy

Process and verify premium payments

Document and track appeals and grievances

Identify process improvements and communicate trends to leadership

Coordinate and collaborate across departments to ensure seamless service delivery

Collect and monitor performance data using tracking tools

What We’re Looking For

Education : High School Diploma or GED required

Experience : 1–3 years in a health plan or customer service setting (Managed Care experience preferred)

Technical Skills : Proficiency in Microsoft Office; familiarity with systems like QNXT or MMIS is a plus

Knowledge, Skills, and Abilities

Understanding of healthcare administration, including Medicaid, Medicare, and other managed care programs

Strong analytical and problem-solving skills

Excellent communication and customer service abilities

Ability to manage multiple priorities and meet deadlines

Comfortable interpreting and applying policies and procedures

Team-oriented, adaptable, and proactive

If you’re passionate about helping others navigate their healthcare coverage and want to be part of a supportive, mission-driven team—we’d love to hear from you!

Apply today to be considered for this exciting opportunity with Lakeshore Talent.

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