Customer Service Representative

Mass Digital Health; Massachusetts; On-site; USD 38,000 - 52,000; Full time

Job summary

Mass Digital Health in Massachusetts is seeking a customer service professional to interpret contract benefits, provide claim status updates, and assist policyholders and providers with timely, accurate information. You will handle inbound calls, place outbound calls, and document interactions for audit trails.

The role requires collaboration with supervisors to maintain service standards and ensure correct responses. Experience in insurance or health benefits customer service is a plus.

Qualifications

• Interpreting contract benefits accurately

Responsibilities

• Interpret contract benefits accurately to policyholder, agents, and providers with a positive and professional approach.
• Provide claim status to policyholders or providers with a positive and professional approach.
• Answer calls as required by company policy in a helpful, professional, timely manner.
• Place outgoing calls as needed to provide or obtain information.
• Document (written/on-line) all calls while in progress.
• Transfer calls to employees in other departments as required to meet customer needs.
• Fully document policy file or imaging system with all related material so as to leave a clear and concise audit trail.
• Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards.
• Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts.

Job description

• Interpret contract benefits accurately to policyholder, agents, and providers with a positive and professional approach.
• Provide claim status to policyholders or providers with a positive and professional approach.
• Answer calls as required by company policy in a helpful, professional, timely manner.
• Place outgoing calls as needed to provide or obtain information.
• Document (written/on-line) all calls while in progress.
• Transfer calls to employees in other departments as required to meet customer needs.
• Fully document policy file or imaging system with all related material so as to leave a clear and concise audit trail.
• Actively participate in cross training and group training sessions to maximize team efficiency and maintain or exceed service standards.
• Communicate openly with Supervisor, Team Lead and other team members to ensure accurate responses and avoid duplication of efforts.