Customer Service Representative (Healthcare TPA)

Concierge Third Party Administrator; Oklahoma City (OK); On-site; USD 32,000 - 48,000; Full time

Benefits offered by this job

Medical, dental, and vision insurance

401(k)

Paid time off

Paid holidays

Job summary

Concierge Third Party Administrator is seeking a Customer Service Representative to be the front line for members, employers, and providers via phone, text, and live chat. You will answer questions about benefits, claims, and eligibility and route complex issues to the right teams.

The role requires patience, organization, and a genuine desire to help people navigate healthcare questions. The position is full-time and in-office with a Monday–Friday schedule.

Qualifications

• 1+ year of customer service experience, preferably in a call center or contact center.
• Clear, professional phone voice and strong written communication for text and chat.
• Able to manage several systems at once while typing accurately.
• Calm, empathetic, and professional with frustrated callers.
• Attention to detail and respect for confidentiality.

Responsibilities

• Handle inbound calls, text messages, and live chats from members, employers, and providers.
• Verify caller identity and protect member health information per HIPAA and policy.
• Explain benefits, coverage, deductibles, copays, and eligibility clearly.
• Look up claim status and explain processing, denials, and next steps.
• Help members find in-network providers and pharmacies.
• Support pharmacy benefit questions, such as drug coverage and prescriptions.
• Document interactions in the administration system.
• Escalate complex issues to relevant teams and follow up until resolved.
• Meet service goals for response time, resolution, and quality.
• Spot recurring issues and share them with leadership to improve processes.

Skills

Customer service

Job description

Concierge Third Party Administrator (CTPA) administers self-funded and Minimum Essential Coverage (MEC) health plans for employer groups across the country. We handle claims, enrollment, eligibility, plan setup, and member and provider support, so employers can offer quality benefits and their employees can actually use them. We're growing quickly, and our service team is the first voice our members hear.

As a Customer Service Representative, you'll be the front line for members, employers, and providers who contact us by phone, text, and live chat. You'll answer questions about benefits, claims, and eligibility, solve problems on the first contact whenever you can, and route anything more complex to the right team. This role suits someone who is patient, organized, and genuinely likes helping people sort out confusing healthcare questions.

Key Responsibilities

• Handle inbound calls, text messages, and live chats from members, employers, and providers.
• Verify caller identity and protect member health information in line with HIPAA and company policy.
• Explain benefits, coverage, deductibles, copays, and eligibility in plain language.
• Look up claim status and explain how a claim was processed, including denials and next steps.
• Help members find in-network providers and pharmacies.
• Support pharmacy benefit questions, such as drug coverage and prescription claims.
• Document every interaction accurately in our administration system.
• Escalate complex issues to claims, enrollment, or eligibility teams and follow up until resolved.
• Meet service goals for response time, resolution, and quality.
• Spot recurring issues and share them with leadership to help improve our processes.

Qualifications

Required

• 1+ year of customer service experience, ideally in a call center or contact center.
• Clear, professional phone voice and strong written communication for text and chat.
• Comfortable handling several systems at once and typing accurately while talking with customers.
• Ability to stay calm, empathetic, and professional with frustrated callers.
• Strong attention to detail and respect for confidential information.
• Located within reasonable distance of our offices in Oklahoma City or Bartlesville, Oklahoma for commute to the office.

Preferred

• Experience at a Third Party Administrator (TPA), health insurance carrier, or medical billing office.
• Familiarity with medical claims, Explanations of Benefits (EOBs), and health insurance terms.
• Bilingual in English and Spanish.

Schedule

This is a full-time, in-office position on a fixed Monday–Friday schedule within our service hours of 7:30 AM–5:00 PM Central. Offices are located in Oklahoma City and Bartlesville, Oklahoma.

• Medical, dental, and vision insurance
• 401(k)
• Paid time off
• Paid holidays

Values That Guide Us

At Concierge, we’re dedicated to meeting our clients’ unique benefits administration needs. Our team strives to create long-term partnerships and meaningful connections based on shared values with those we serve.

Empower Others

We empower those we serve to have an active role in their benefit plan administration.

Deliver Responsive Service

Our timely, sincere approach extended to offering flexible services to those we serve.

Be Humble

Being humble helps us focus less on ourselves and more on delivering for you.

Live by the Golden Rule

We treat others the way we want to be treated—kindness, understanding and humility.

We stay open-minded and willing to find new ways to solve problems as they appear.

Have Fun

Because life is meant to lived with joy!