Customer Service Representative

Talentify; Somerville (MA); Remote; USD 28,000 - 39,000; Full time

Job summary

Mass General Brigham Health Plan is seeking a Customer Service Professional (CSP) who will serve as the primary contact for members and providers, delivering first-call resolution and high-quality service. You will troubleshoot inquiries about eligibility, benefits, and claims, and navigate multiple systems to ensure accurate responses and timely resolutions.

You will contribute to a compliant, customer-focused experience, build trust with customers, and support ongoing member satisfaction while

Qualifications

• High school diploma or equivalent required.
• Associate's degree in related field preferred.
• Strong customer service skills; clear, concise communication.

Responsibilities

• Serve as primary liaison for members and providers across lines of business.
• Handle benefit, claims and eligibility calls; research information as needed.
• Document interactions and escalate issues when appropriate.
• Navigate multiple systems to resolve customer inquiries and complaints.

Skills

Exceptional Customer Service

Multitasking

Call Center experience

Service Excellence

Accountability

Critical Thinking

Team Player

Flexible/Adaptable

Relationship Building

Education

High School Diploma or Equivalent

Associate's Degree in related field

Job description

Site: Mass General Brigham Health Plan Holding Company, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

The Opportunity

The Customer Service Professional (CSP) acts as the primary point of contact for our members, providers and other key stakeholders focusing on exceptional customer satisfaction and first call resolution.

The CSP’s interact with customers to provide information and troubleshoot complex issues in response to inquiries about coverage, benefits, services, and to handle and resolve complaints.

The Customer Service Rep in this role must be committed to building customer confidence and increasing customer satisfaction by delivering to callers an exceptional experience focused on quality and accuracy.

The CSP’s will be initially trained on member demographic changes and benefit inquires. Additional member claims training will be delivered ±60 days after CSP has completed benefits and eligibility training After successfully demonstrating core competencies by meeting or exceeding key performance measurements, the individual will be trained to handle Provider claims inquiries as business needs dictate.

Qualifications

The CSP is Responsible For

• Serves as the primary liaison for members and providers for all lines of business including MassHealth, and Commercial members regarding general program inquires such as eligibility verifications, authorizations, referrals, claims, material fulfillment, address changes and Primary Care Physician assignments as well as member related policy and procedures.
• The CSP must be able to handle and demonstrate skills in handling benefits, claims and eligibility calls for the member and provider population.
• Identify customer issues/concerns rapidly and precisely
• Research required information using available resources and triage when necessary
• Handles and resolve customer inquiries and complaints, exhausting all efforts within the CSP’s scope before requesting assistance
• Identify and elevate priority issues in order to create efficiencies
• Initiates follow up customer calls where necessary
• Complete call logs to record customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
• Refer customer grievances and appeals to designated departments for further investigation
• Responsible for navigating multiple systems in order to resolve customer issues
• Acts as the primary representative for Mass General Brigham Health Plan for our customers focusing on first call resolution and customer engagement.
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.

Qualifications and Skills for Success

• High School Diploma or Equivalent required
• Associate's Degree in related field or Healthcare Management preferred
• Exceptional Customer Service skills, both verbal and written communication must be concise, clear, compliant, personable and professional
• Ability to multi task and prioritize
• Call Center experience a plus
• Maintain Customer Service Behavior Competencies
• Flexibility/Adaptability/Willingness/Team Player/ Positive Attitude
• Relationship Building/Caring
• Service Excellence/Accountability/Critical Thinking

Additional Job Details (if applicable)

Additional Job Description

Working Model Required

Monday - Friday EST hours:

• First one full Month Training Schedule: M-F 8:30 AM – 5:00 PM EST
• Post Training Schedule: 9:00 AM – 5:30 PM (Mon, Tue, Wed, and Fri) with 11:30 AM – 8:00 PM (Thurs) (EST) or 9:30 AM – 6:00 PM (Monday-Friday) EST

This is a remote position; a quiet, secure, stable, and compliant workstation is required from within the US, with MGB-provided equipment and Video required during the work week

Start Date required: November 2, 2026

Remote Type

Remote

Work Location

399 Revolution Drive

Pay Range

$19.81 - $28.30/Hourly

Grade

3

At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

8925 Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.