Healthcare Customer Service Representative

Customer Service RepresentativeInsight Global is seeking a Customer Service Representative to support a healthcare organization's member and provider call center. This individual will handle inbound inquiries from members and providers, research claims and benefit-related questions, and work toward timely resolution. The role involves reviewing claims and appeals, clarifying denial information, documenting interactions, and coordinating with internal teams such as Claims, Network Management, and Medical Management when additional support is needed. This is a remote position with virtual training available. Key responsibilities include:Answer inbound member and provider calls and respond to inquiries received through phone, mail, and online channelsReview claim status, appeals, and denial information and explain findings to callersResearch questions using internal systems, reference materials, and available claims documentationDocument caller contacts, actions taken, and follow-up items in the appropriate systemCoordinate and escalate complex issues to Claims, Network Management, Medical Management, or other appropriate teamsCoordinate with insurance companies when needed to resolve member or provider issuesSubmit check tracers and assist with member/provider satisfaction surveysProvide basic technical support and escalate more complex technical issues when necessary