Customer Service Representative

Quantum Recruiters Inc; Eugene (OR); On-site; USD 40,000 - 54,000; Full time

Job summary

Quantum Recruiters Inc in Eugene, Oregon is seeking a Customer Service Representative to provide excellent phone-based service for coverage and claims questions. You will interpret benefits, research disputes, and ensure accurate documentation, with outbound outreach as needed.

Strong communication, healthcare knowledge, and high school completion are required; HIPAA compliance is emphasized. This temp-to-hire role supports high-volume operations and professional, compassionate service.

Qualifications

• One year of medical insurance or healthcare related experience required.
• Experience in a call center or customer service environment preferred.
• Strong written and verbal communication skills with good overall computer skills.

Responsibilities

• Provide excellent customer service primarily by telephone to all customers.
• Assist customers with coverage/claims related questions and interpret benefits.
• Research and follow up for prompt resolution of disputed claims.
• Document calls clearly in the computer system and relay information to departments.
• Make outbound calls to members as necessary for outreach campaigns.

Skills

Medical insurance experience

Healthcare experience

Call center experience

Strong communication

Typing / 10-key

Education

High School Diploma or equivalent

Tools

Typing

10-key

Job description

Job Description - Customer Service Representative

Provide excellent customer service primarily by telephone to all customers. Assist customers with coverage/claims related questions. Accurately interpret benefits and policy provisions for all products. Conduct appropriate research and follow-up for prompt resolution of disputed claims. Temp to hire opportunity!

Essential Responsibilities:

• Work efficiently in a high volume call center while maintaining a professional, positive, and caring demeanor.
• Assist callers with coverage related questions/concerns; accurately interpret policy provisions for assigned products.
• Analyze customer’s inquiries and determine correct steps for resolution, interpret benefit information, and claims processing accuracy.
• Keep resource information up to date and well organized.
• Work efficiently in multiple systems simultaneously while effectively utilizing critical thinking and problem solving skills.
• Document calls in a clear and consistent manner in computer system.
• Conduct appropriate research, take ownership and follow through for prompt resolution of disputed claims.
• Relay information to appropriate departments and personnel using established communication channels and procedures.
• Make outbound calls to members as necessary dependent upon current outreach campaign.

Supporting Responsibilities:

• Meet department and company performance and attendance expectations.
• Be aligned with company values.
• Follow the privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
• Perform other duties as assigned.

SUCCESS PROFILE

• Work Experience: One-year medical insurance, other healthcare related field, call center or customer service experience required.
• CPT/ICD-10 coding preferred.
• Education, Certificates, Licenses: High School Diploma or equivalent required.
• Knowledge: Basic understanding of insurance and medical terminology, coding and standard medical billing practices preferred.
• Proficient computer skills, typing, and 10-key required.
• Strong written and verbal communication skills.