Customer Service Representative

AppleOne; Guaynabo (PR); On-site; USD 21,000 - 30,000; Full time

Benefits offered by this job

Major medical

Dental

Vision

401k

Sick pay as required

Job summary

AppleOne Employment Services is seeking a Customer Service Representative to act as the primary liaison between a recognized health insurance organization and its members and providers. You will handle calls, guide on benefits, enrollment and claims, resolve inquiries and document interactions, while supporting retention and achieving quality metrics.

The role requires an Associate degree and 1–3 years in health insurance, with strong communication and problem-solving abilities.

Qualifications

• Associate degree (60–64 credits) in Business Administration, Arts or Science.
• 1–3 years of experience in the health insurance industry, preferably in sales or a call center.
• Excellent communication, customer service and problem-solving skills.

Responsibilities

• Handle inbound and outbound calls, guiding members on benefits, enrollment, claims and coverage changes.
• Resolve customer inquiries, complaints and service issues; escalate when needed.
• Conduct follow-up calls and document interactions in the systems.
• Support member retention and satisfaction while meeting productivity and quality goals.

Skills

Customer service skills

Communication skills

Problem-solving

Education

Associate degree in Business Administration/ Arts or Science

Job description

We are seeking a Customer Service Representative to serve as the primary liaison between a recognized health insurance organization and its members and providers. Responsibilities: Handle inbound and outbound calls, providing guidance on benefits, enrollment, claims, and coverage changes. Resolve customer inquiries, complaints, and service issues, escalating cases when necessary. Conduct follow-up calls and document interactions in the appropriate systems. Support member retention and satisfaction while meeting productivity and quality goals.

Requirements: Associate degree (60–64 college credits) in Business Administration, Arts, or Science. 1–3 years of experience in the health insurance industry, preferably in sales or a call center environment. Excellent communication, customer service, and problem-solving skill

Equal Opportunity Employer / Disabled / Protected Veterans

The Know Your Rights poster is available here: https://www.eeoc.gov/sites/default/files/2023-06/22-088_EEOC_KnowYourRights6.12.pdf

The pay transparency policy is available here: https://www.dol.gov/sites/dolgov/files/ofccp/pdf/pay-transp_%20English_formattedESQA508c.pdf

For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

https://e-verify.uscis.gov/web/media/resourcesContents/E-Verify_Participation_Poster_ES.pdf

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.