Healthcare Customer Service Representative

Job title: Healthcare Customer Service Representative


Location (city, state): Rockville, MD - Fully Onsite


Industry: Healthcare / Health Benefits / Customer Service


Pay: $25-$28/hour


Benefits: This position is eligible for medical, dental, vision, life insurance and 401k.


About Our Client:


Addison Group is partnering with a healthcare benefits organization seeking a Healthcare Customer Service Representative . This role is ideal for customer service professionals with healthcare experience who enjoy helping individuals understand their benefits, claims, eligibility, and other plan-related questions.


Job Description:


The Participant Advocate will provide professional and empathetic support to participants in a high-volume, call center-style environment. This position involves researching benefits and claims questions, explaining coverage, resolving concerns, and helping participants navigate their healthcare benefits.


Key Responsibilities:

• Assist participants by phone, email, in person, and written correspondence.
• Answer questions regarding eligibility, benefits, claims, payments, and plan coverage .
• Explain claim payments and help participants understand denied claims.
• Verify eligibility and benefits and coordinate necessary updates.
• Research participant concerns and determine appropriate solutions.
• Accurately document all participant interactions.
• Assist with enrollment forms, disability claims, and other benefit-related processes.
• Collaborate with internal departments, providers, vendors, and employers to resolve issues.
• Escalate complex concerns when additional assistance is required.

Requirements:

• 2+ years of receptionist, scheduling, call center, or customer service experience required.
• Healthcare experience involving direct patient or customer communication required.
• TPA, insurance carrier, or healthcare benefits experience preferred.
• Experience handling high-volume calls or customer interactions.
• Strong customer service, communication, and problem-solving skills.
• Professional, empathetic, reliable, and detail-oriented.
• Proficiency with Microsoft Word and basic computer systems.
• Minimum typing speed of 40 WPM required.

Additional Details:

• 100% onsite, Monday-Friday.
• Regular schedule: 8:00 AM-5:00 PM .
  • Must be open to a potential 10:00 AM-7:00 PM schedule.
• Approximately 6-8 weeks of structured training provided.
• Consistent attendance and punctuality are required throughout training and employment.

Perks:

• Comprehensive, structured training program.
• Consistent Monday-Friday schedule.
• Build experience with healthcare benefits, eligibility, claims, and insurance.

Addison Group is an Equal Opportunity Employer. Addison Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Addison Group complies with applicable state and local laws governing non-discrimination in employment in every location in which the company has facilities. Reasonable accommodation is available for qualified individuals with disabilities, upon request.


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