Remote Healthcare Customer Service Representative

Conduent Commercial Solutions, LLC; United States; Remote; USD 33,000 - 34,000; Full time

Benefits offered by this job

Health insurance

Dental and vision programs

Life and disability insurance

Retirement savings plan

Paid holidays

Job summary

Conduent Commercial Solutions, LLC is seeking a Remote Call Center Representative to handle inbound inquiries regarding dental benefits for Commercial and Medicare plans. The role emphasizes accurate benefit interpretation, issue resolution, and documentation within the billing system.

You will navigate multiple systems and aim to meet monthly performance metrics. The position requires at least a high school diploma and 1 year of call center or in-person customer service experience, with

Qualifications

• High school diploma, GED, or college degree.
• At least 1 year of call center experience preferred.
• 1 year of face-to-face customer service experience.
• Knowledge of Dental/Medical/Managed Care industry preferred.
• Strong written and verbal communication; multitasking and problem solving.

Responsibilities

• Respond to inbound inquiries regarding dental benefits, eligibility, claims, appeals, grievances, and provider searches for both Commercial and Medicare plans.
• Provide uniform interpretation and clarification of dental benefits, policies, and procedures to members, providers, and employer groups.
• Investigate issues, contact appropriate parties, and document interactions in the billing system.
• Investigate verbal complaints regarding billing, claims, or services; escalate as needed.
• Retrieve and send written correspondence, plan brochures, and provider directories.
• Meet or exceed call volume and quality performance goals.

Skills

Communication skills

Phone communication

Analytical thinking

Team player

Customer service mindset

Education

High school diploma or higher

Tools

Microsoft Word

Microsoft Outlook

Internet Explorer

Job description

Through our dedicated associates, Conduent delivers mission‑critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Remote Call Center Representative
Would you enjoy being part of a team that makes a difference in people’s lives? Do you love helping people solve complex problems and deliver solutions? We are looking for people with a passion for helping others, naturally empathy, and are determined to deliver a comprehensive solution to healthcare‑related calls. To be successful customer service experience is a plus, but not a requirement.

Conduent has plenty of growth opportunities within the healthcare team.

• The pay rate is $16 per hour, which may be below your state’s minimum wage. Please take this into consideration when applying.
• Training is 5 weeks classroom and 2 weeks nesting.
• Successfully complete a mandatory paid training program with 100% attendance.
• Hours of operation: Monday — Sunday 7:30am — 11:00pm EST
• Medical, dental and vision benefits are available on the 1st day of employment.
• Paid time off is accrued after 180 days (about 6 months) of employment.
• Successfully navigate 6 systems and average 32 calls per day.

Responsibilities for Remote Call Center Representative:

• Respond to inbound inquiries regarding dental benefits, eligibility, claims, appeals, grievances, and provider searches for both Commercial and Medicare plans.
• Provide uniform interpretation and clarification of dental benefits, policies, and procedures to members, providers, and employer groups.
• Actively attempt to resolve member or provider concerns by investigating issues, contacting appropriate parties, and documenting all interactions accurately within the billing system.
• Investigate verbal complaints regarding billing, claims, or services rendered; elevate service failures to appropriate internal departments for follow‑up and resolution.
• Retrieve and send written correspondence, including plan brochures, provider directories, and other printed materials as needed.
• Meet or exceed established ACD (Automated Call Distribution) system call volume and quality performance goals.
• Achieve all assigned individual monthly performance metrics.
• Maintain current and thorough knowledge of all Member Services policies, procedures, and dental plan updates.
• Perform additional duties and responsibilities as assigned by management.

Requirement for Remote Call Center Representative:

• Successfully complete customer service assessment & typing test.
• High school diploma, GED, or college degree
• At least 1 year of Call Center experience preferred.
• 1 year of face‑to‑face customer service experience.
• Knowledge of and prior experience in the Dental, Medical or Managed Care industry is preferred.
• Must possess the following characteristics: self‑motivation, resourceful, detail‑oriented, sense of accountability and must be a team player.
• Must possess strong skills in the following areas: organizational, time management, written and verbal communication, analytical, and problem solving.
• Proficiency in Microsoft Word, Microsoft Outlook, and Internet Explorer.
• Effective communication skills over the phone.
• Ability to deal with problems involving several concrete variables in standardized situations.
• Successful completion of background check is required for this position.

Equipment and workspace requirements:

• We provide all equipment. (Computer, Monitor, Mouse, Keyboard, Headset, Ethernet Cord, Power Cables)
• You must have a home internet connection of 10 Download and 3 Upload Speed (you may do a quick check through https://www.speedtest.net/)
• Must be able to hardwire your work computer directly to your home modem via ethernet. Ensure the available connection meets the minimum bandwidth requirements to perform your job function. Satellite internet and wireless internet are not acceptable.
• Must have a distraction free and secure work environment. (Workspace must be clutter free, free of distraction, no one is allowed in workspace during working hours, no writing utensils, or unauthorized electronics in the work area).

The application process will take less than 20 minutes and includes everything required to be considered.

Important:

Due to varying state and local minimum wage laws, we are currently only able to hire candidates residing in states where our compensation structure complies with applicable wage regulations. As a result, we may be unable to consider applicants from certain states or municipalities at this time. We are currently NOT hiring in the following geographies, including but not limited to: States: AK, CA, CT, HI, IL, MA, MD, MT, NJ, NY, OR, WA Metro Areas: Minneapolis – MN, Washington, DC, Denver/County of Boulder/Edgewater County – CO

Be part of the future

Are you seeking an opportunity to make a real impact in a company that appreciates ideas and new ways of thinking? Come join us and grow with a team of people who will challenge and inspire you to be the best!

Pay Transparency Laws in some locations require disclosure of compensation and/or benefits‑related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated salary range for this role is $16.00/hour.

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to [email protected]. You may also click here to access Conduent’s ADAAA Accommodation Policy.