Customer Service Representative

Job Summary

We are seeking a Healthcare Customer Service Representative for a direct hire, remote customer support opportunity supporting members, pharmacies, and healthcare providers. This role is ideal for a service-focused professional who enjoys helping people, solving problems, and working in a fast-paced inbound call center environment.

As a Healthcare Customer Service Representative, you will assist callers with prescription benefits, pharmacy services, billing, eligibility, claims, authorizations, and medication delivery questions. You will receive structured classroom training, live-call support, company-provided equipment, and guidance from experienced supervisors and managers. This is a great opportunity to join a stable, team-oriented remote support environment with clear expectations, supportive leadership, and the opportunity to build valuable healthcare customer service experience.

Candidates must reside outside of Santa Fe County, NM to be eligible for this position, based on the client’s geographic eligibility requirements.

Key Responsibilities

- Handle high-volume inbound customer service calls from members, pharmacies, and healthcare providers.
- Assist callers with prescription benefits, home-delivery medications, billing, payments, eligibility, coverage, claims, authorizations, and delivery status questions.
- Research and resolve customer issues using multiple computer systems and internal resources.
- Actively listen, ask appropriate questions, identify solutions, and work toward first-call resolution.
- Accurately document customer interactions and complete follow-up calls when needed.
- Meet established expectations for quality, productivity, attendance, and customer experience.

Compensation and Benefits

- Pay rate: $16.50 per hour.
- Bilingual pay rate: $18.00 per hour.
- Job type: Direct hire.
- Work environment: Remote.
- Schedule: Monday through Sunday, 8:00 AM to 8:00 PM MST.
- Shift length: 8.5 hours, including a 30-minute unpaid lunch.
- Start date: November 9.
- Training: 22 days of classroom training followed by 5 days of ABAY handling live calls from members.
- Equipment: Company-provided equipment.
- Home internet: Hardwired Ethernet connection is required. WiFi is not accepted.

Required Qualifications and Skills

- Provide inbound customer support for healthcare, pharmacy, prescription benefit, billing, eligibility, claims, and medication delivery questions.
- Navigate multiple systems to research issues, document calls, and provide accurate information.
- Support first-call resolution by listening carefully, asking probing questions, and identifying appropriate solutions.
- Maintain productivity, quality, professionalism, and attendance standards in a remote call center environment.

- Must be at least 18 years of age.
- High School Diploma, GED, or equivalent required.
- Minimum of 1 year of customer service experience required.
- Basic computer proficiency and the ability to learn multiple systems quickly.
- Basic Microsoft Word and Excel skills.
- Strong verbal communication, active listening, problem-solving, and customer care skills.
- Ability to work in a high-volume, fast-paced inbound call center environment.
- Flexible availability to work evenings, weekends, holidays, and occasional overtime.
- Must have a private, dedicated, distraction-free workspace with a lockable door or private space.
- Must have a hardwired Ethernet internet connection with minimum speeds of 50 Mbps download and 10 Mbps upload.
- 5G, hotspot, and satellite internet connections are not supported.
- Must remain on camera during working hours.
- Must be able to complete an online assessment, recruiter screening, ID verification, background check, and 4-panel drug test. Marijuana or THC is not included in the drug test.

Preferred Qualifications

- Previous call center experience.
- Previous healthcare, pharmacy, prescription benefits, insurance, or claims customer service experience.
- Bilingual communication skills.

Equal Opportunity Employer / Disabled / Protected Veterans

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For temporary assignments lasting 13 weeks or longer, AppleOne is pleased to offer major medical, dental, vision, 401k and any statutory sick pay where required.

We are committed to working with and providing reasonable accommodations to individuals with disabilities. If you need a reasonable accommodation for any part of the employment process, please contact your staffing representative who will reach out to our HR team.

AppleOne participates in the E-Verify program in certain locations as required by law. Learn more about the E-Verify program.

We also consider for employment qualified applicants regardless of criminal histories, consistent with legal requirements, including, if applicable, the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance. Pursuant to applicable state and municipal Fair Chance Laws and Ordinances, we will consider for employment-qualified applicants with arrest and conviction records, including, if applicable, the San Francisco Fair Chance Ordinance. For Los Angeles, CA applicants: Qualified applications with arrest or conviction records will be considered for employment in accordance with the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act.