Healthcare Customer Service Representative - Starts 7/07

Lensa; Raleigh (NC); Remote; Full time

Job summary

A leading non-profit healthcare system is seeking a Healthcare Customer Service Representative in Raleigh, NC. This fully remote position requires effective communication and problem-solving skills to assist members with various healthcare inquiries. Candidates must have a high school diploma and at least two years of customer service experience.

Benefits

Medical, dental & vision insurance

401(k) Retirement Plan

Short and long-term disability

Employee Assistance Program

Paid Time Off (PTO)

Qualifications

• 2+ years of customer service or call center experience, preferably remote.
• Consistent work history and knowledge of medical claims.
• Proficient in Microsoft Office.

Responsibilities

• Resolve member inquiries about enrollment, eligibility, and benefits.
• Educate members on health care policies and procedures.
• Document calls and track issues reported by customers.

Skills

Call center experience

Customer service

Problem-solving

Education

High school diploma / GED

Tools

Microsoft Office

Job description

Healthcare Customer Service Representative - Starts 7/07

Healthcare Customer Service Representative - Starts 7/07

1 week ago Be among the first 25 applicants

Lensa is the leading career site for job seekers at every stage of their career. Our client, TEKsystems, is seeking professionals in Raleigh, NC. Apply via Lensa today!

Join a large non-profit Healthcare system based in MN!

Job Description

• This position is responsible to apply knowledge of the company's business, products, members and operations to accurately and effectively fulfill member service requests and inquiries. Ensure adherence to policies and procedures and meet service level expectations by following established guidelines and standards. Achieve fluency in at least one core product or service line
• Answer, resolve, track and document telephone calls from members, providers, internal departments, and external agencies, in a timely and professional manner. Research, resolve and communicate effectively with internal and external customers regarding member/provider concerns or issues. Educate members and external customers on policies and procedures related to members’ health care program.
• Research and resolve inquiries from internal /external customers including: Enrollment, eligibility, ID cards, clinic changes, demographic changes, benefit coverage, claims, payments, member reimbursement, and demonstrated knowledge of CAG policies, procedures, and regulations. Utilize appropriate resources to respond to member inquiries.
• Answer, resolve, track and document telephone calls from members and providers in a timely and professional manner. Interpret member eligibility and coverage through thorough knowledge of the contracts, policies and procedures. Communicate with internal departments, members, providers and other customers regarding the transportation benefit in both verbal and written form, including faxing rides to providers at the appropriate times.
• Identify trends/issues that emerge in calls/correspondence, and inform Team Lead or Supervisor. Assist in the development and communication of resolutions to internal staff, as requested
  
  

Main Position Details

Start: 7/07

Pay: $23/Hr - $24/Hr

Schedule: Must be available Monday - Sunday between 8:00am - 8:00pm CST

Location: 100% remote. Equipment will be provided

Skills & Qualifications

• High school diploma / GED
• 2+ years of call center experience, preference given to someone who has worked from home.
• Consistent work history
• Preference given to candidates with health insurance (HMO), physician group practice, or community agency
• Working knowledge of medical claims and/or medical billing processess.
• Proficient computer skills: knowledge of Microsoft office
  
  

Pay and Benefits

The pay range for this position is $23.00 - $24.00/hr.

Requirements

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)
  
  

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Jun 13, 2025.

About TEKsystems And TEKsystems Global Services

We’re a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We’re a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We’re strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We’re building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com.

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Seniority level

• Seniority level

  Entry level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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