Call Center Representative

A company is looking for a Call Center Representative who will handle direct communications with members, providers, and health plans.

Key Responsibilities

Directly communicate with members, providers, and health plans to confirm benefits and eligibility

Provide claim status and resolve customer complaints by identifying issues and offering resolutions

Respond to inquiries regarding plan benefits and follow up on unresolved issues

Required Qualifications

1+ year of Member Services experience in the Healthcare industry

Proficient with computers

Bilingual in English and Spanish

Strong understanding of health plan terminology (preferred)

Experience with NextGen (preferred)