Healthcare Customer Representative

Job Title : Healthcare Customer Representative

Location : Lake Mary, FL (255 Technology Park)

Duration : $6+ month

Work Setup : Hybrid – Primarily Work From Home, but onsite attendance required for the first day and as needed for events or training.

Pay : $16.25

Position Summary :

The Customer Service Associate Representative provides administrative and customer service support to members, providers, and internal departments within Core Sales Support team. The role focuses on resolving inquiries related to policies, claims, and orders while maintaining a high level of professionalism and accuracy.

You’ll be the first point of contact for customers—answering calls, responding to emails, processing requests, and routing documentation to appropriate departments. This position requires strong communication skills, attention to detail, and the ability to work in a structured environment following established procedures.

Key Responsibilities :

• Handle inbound and outbound calls from members, providers, and facilities regarding claims, policies, and benefits.
• Research and interpret policy provisions to determine appropriate responses.
• Route claim forms and documentation to relevant units for processing.
• Record and maintain detailed and accurate case information in the system.
• Respond to inquiries, grievances, and complaints within defined service levels.
• Follow established procedures and escalate complex cases as needed.
• Collaborate with internal departments to ensure timely resolution of member concerns.
• Support administrative tasks such as data entry, file maintenance, and sorting requests.

Required Skills (Non-Negotiable) :

Preferred Skills :

Education & Experience :

Additional Information :