Remote Commercial Health Plan Support Specialist

Lever, Inc.; Northern (KY); Hybrid; USD 50,000 - 61,000; Full time

Benefits offered by this job

Competitive salary

Health, dental, and vision insurance

Retirement plan with company match

Generous time off

Professional development

Remote work environment

Job summary

Evry Health is seeking a Customer Service Representative to be the primary human contact for members and providers, handling inbound/outbound calls and emails with empathy and accuracy. You will explain benefits, eligibility, and claims using CPT/ICD-10 codes, while collaborating with internal teams to resolve complex issues.

Remote role within the United States (CST/EST). Requires 2+ years in customer service for commercial health plans and proficiency with Microsoft 365; Salesforce experience

Qualifications

• High school diploma or equivalent is required.
• 2+ years of customer service experience supporting commercial fully insured health plan business.
• Working knowledge of commercial health plan benefits, eligibility & claims processes.
• Demonstrated knowledge of CPT, ICD-10, HCPCS & Revenue Codes; Microsoft 365 proficiency.

Responsibilities

• Resolve member and provider inquiries with accurate information.
• Explain plan benefits, eligibility, and claims decisions.
• Own initial intake and documentation of escalated situations.
• Collaborate with Claims, Medical Management, and other teams; document interactions in CRM.
• Monitor trends and assist members with portal navigation.

Skills

Customer service

Health plan knowledge

Microsoft 365

Education

High school diploma

Associate's or Bachelor's degree (preferred)

Tools

Salesforce

Job description

Evry Health is seeking a Customer Service Representative to be the primary human contact for members and providers, handling inbound/outbound calls and emails with empathy and accuracy. You will explain benefits, eligibility, and claims using CPT/ICD-10 codes, while collaborating with internal teams to resolve complex issues.

Remote role within the United States (CST/EST). Requires 2+ years in customer service for commercial health plans and proficiency with Microsoft 365; Salesforce experience