Call Center Representative

Job Summary

The Participant Advocate provides phone and customer service support to individuals with healthcare and benefits-related questions. This role requires strong communication skills, empathy, attention to detail, and the ability to research and resolve customer concerns. Training will be provided on specific benefits and systems.

A high number of candidates may make applications for this position, so make sure to send your CV and application through as soon as possible.

Responsibilities

• Handle inbound calls and respond to customer questions regarding healthcare benefits, eligibility, claims, and payments.
• Research customer issues and provide accurate information and solutions.
• Explain claim details, payments, and denials in a clear and easy-to-understand manner.
• Verify eligibility and benefit information and assist with updates when needed.
• Work with healthcare providers, vendors, employers, and internal teams to resolve customer issues.
• Assist customers with forms, enrollment, claims, and other healthcare-related processes.
• Help customers navigate online resources and benefit information.
• Document all customer interactions accurately and maintain detailed records.
• Identify and escalate complex issues when additional assistance is required.
• Maintain a professional, patient, and empathetic approach when handling sensitive or difficult situations.
• Participate in team projects and provide support to other departments as needed.

Qualifications

• 1+ year of call center experience in a medical, healthcare, insurance, or related environment required.
• High School Diploma required.
• Experience handling high-volume inbound calls preferred.
• Strong verbal and written communication skills.
• Excellent customer service and problem-solving abilities.
• Strong attention to detail and ability to maintain accurate records.
• Ability to research issues and explain information clearly.
• Proficiency with Microsoft Office.
• Dependable, professional, and comfortable working in a team environment.
• Ability to remain calm, patient, and positive when handling challenging customer situations. xhyhwjd
• Willingness to learn new healthcare benefits, systems, and processes.

Schedule

• Full-time, in-office position
• Monday through Friday
• 40 hours per week
• Standard business hours, with potential for a later shift