Call Center Representative

About this job Customer Service Representative – Healthcare Remote Role Duration: 6 months Job Summary We are seeking a Customer Service Representative to handle incoming calls and assist customers with questions, complaints, and service requests. The ideal candidate will have strong communication skills, attention to detail, and experience in a customer service or healthcare environment. Key Responsibilities Answer incoming calls and respond to customer inquiries promptly, accurately, and professionally. Assist customers, providers, physicians, hospitals, beneficiaries, and other healthcare partners. Develop and maintain knowledge of company policies, procedures, and services. Use automated systems to retrieve and document information and perform accurate data entry. Respond to inquiries received by phone, email, fax, or mail within required turnaround times. Verify healthcare services to support accurate payment processing. Review medical claims based on established CPT/DRG audit criteria and submit required billing information. Investigate, resolve, and investigate provider or customer issues as appropriate. Serve as a liaison between internal teams and external healthcare partners. Collect and enter demographic, provider, and procedure information to initiate cases. Meet or exceed established standards for call volume, quality, and service levels. Complete daily, monthly, and quarterly reports as required. Maintain confidentiality and comply with HIPAA and all applicable privacy and security policies. Maintain regular and reliable attendance and work scheduled hours as required. Required Qualifications High School Diploma or equivalent. Minimum of 2 years of customer service experience. Strong verbal, written, and active listening skills. Strong attention to detail and data-entry accuracy. Ability to work effectively in a fast-paced, customer-focused environment. Preferred Qualifications Knowledge of medical terminology or completion of medical terminology coursework. Knowledge of the health insurance industry. Previous healthcare customer service or provider support experience. Bilingual Spanish/English skills are a plus. Primarily a desk-based position requiring extended computer use. Must be able to work scheduled hours and meet daily job responsibilities in a timely manner. Metasys Technologies is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identify, national origin, veteran or disability status. #J-18808-Ljbffr