Customer Service Representative

Job Description

Job Description

Description:

Join our team at Cobalt Benefits Group and start an exciting new career in employee benefits solutions. As a Customer Service Representative (CSR), you’ll play an important role in helping us offer customized, self-funded insurance options to our clients and members.

The Customer Service Representative is responsible for responding to inbound inquiries from members, providers, and partners regarding health plan benefits, eligibility, claims, authorizations, and account information. This position requires excellent communication skills, the ability to navigate multiple systems, and a commitment to providing accurate and timely information while adhering to established policies, procedures, and compliance standards.

Responsibilities

• Handle high-volume inbound calls with professionalism, empathy, and accuracy.
• Provide clear, accurate information regarding health insurance benefits, claims, billing, and eligibility.
• Assist members in navigating online resources and submitting requests.
• Document all call interactions in customer management systems in compliance with company and regulatory requirements.
• Adhere to call handling standards, including average handle time, quality scores, and first call resolution targets.
• Follow compliance guidelines including HIPAA, CMS, and state-specific regulations.
• Escalate complex issues appropriately to ensure timely resolution.
• Stay current with updates to health plan policies, systems, and processes.
• Contribute to continuous improvement by identifying trends and opportunities for enhanced customer experience.

• High school diploma or equivalent (associate or bachelor’s degree preferred).
• 1–2 years of customer service experience; prior call center or healthcare/insurance experience preferred.
• Strong verbal, written, and interpersonal communication skills, with the ability to simplify complex information.
• Proficiency in Microsoft Office (Outlook, Word, Excel, Teams) and ability to learn new software systems quickly.
• Excellent documentation and data entry accuracy.
• Strong reading comprehension skills.
• Ability to work in a structured, fast-paced environment while meeting productivity and quality metrics.
• On-camera presence essential for training and meetings.

Preferred Qualifications

• Familiarity with HIPAA, ERISA, and healthcare benefit plan terminology.

Personal Attributes

• Customer-focused service orientation.
• ·Attention to detail and accuracy.
• Strong problem-solving and organizational skills.
• Adaptability and resilience in high-volume environments.
• Professional demeanor and team-oriented mindset.

Work Environment & Physical Demands

• Prolonged periods of sitting and computer use required.
• Regular use of a headset and participation in video meetings with camera on.
• Employees should ensure an ergonomically appropriate desk and chair setup.
• Reasonable accommodation will be provided as needed.

Schedule & Attendance

• Customer Service Representatives are expected to maintain regular and reliable attendance and to work during assigned shifts to ensure adequate coverage for incoming calls and service commitments. While Cobalt Benefits Group will make reasonable accommodations in accordance with the ADA and applicable laws, this position requires adherence to designated schedules, consistent availability during business hours, and timely communication regarding any changes to availability or attendance.

Benefits

• Fantastic medical, dental, and vision insurance*
• Twice annual employer HSA contributions, covering 50% of the HDHP plan’s annual deductible!
• Company-provided Basic Life and AD&D
• Company-paid Short-Term and Long-Term Disability**
• Flexible Spending Accounts*
• 401(k) Retirement Plan with up to a 6% employer match** (100% fully vested after 3 years)
• 10+ paid holidays
• Generous paid vacation and sick time
• Annual Volunteer Paid Day
• Annual Tuition Reimbursement
• Annual Health and Wellness Reimbursement
• Lots of fun company events
• *60-day waiting period **90-day waiting period
  

Who We Are

As a trusted Third-Party Administrator (TPA) specializing in self-funded benefit plans, Cobalt Benefits Group (CBG) is committed to helping employers find high-quality coverage at a cost they can afford. We administer self-funded insurance benefits through our three companies: EBPA, Blue Benefit Administrators of Massachusetts, and CBA Blue.With over 30 years of experience and a dedicated team of more than 200 employees, we work collaboratively to build customized self-funded health plans, manage claim payments and disputes, and administer other specialized programs such as FSAs, HSAs, COBRA, and retiree billing. Join us as we match employers across our region with the right solutions for their employee benefit needs. To learn more about working at CBG, visit