Customer Service Representative II [Remote]

This position is listed on behalf of a partner company, who manages all applications and next steps. Our partner is looking for a Customer Service Representative II based in the United States.

This role is a key frontline position responsible for delivering high-quality, compassionate, and efficient support to members and providers within a healthcare environment. The Customer Service Representative II ensures accurate and timely resolution of inquiries while handling sensitive information with care and compliance. Working in a structured remote setting, the role involves managing inbound and outbound calls, researching claims and benefit questions, and providing clear guidance to diverse audiences including members, clinics, hospitals, and vendors. It requires strong communication skills, attention to detail, and the ability to navigate multiple systems simultaneously. The position plays a critical role in ensuring first-call resolution and improving the overall customer experience. It also offers extensive training and exposure to healthcare operations and insurance processes.

Accountabilities:

• Handle inbound and outbound customer service interactions, ensuring first-call resolution and providing accurate information regarding claims, benefits, and coverage.
• Research and resolve member and provider inquiries, escalating complex issues to appropriate departments when necessary.
• Document all customer interactions thoroughly and maintain accurate records in compliance with internal and regulatory standards.
• Follow up on pending requests and ensure timely resolution of outstanding items across systems and workflows.
• Communicate clearly and professionally with members, healthcare providers, and external vendors across multiple regions.
• Maintain strict adherence to confidentiality requirements, including handling of Personal Protected Information (PPI) and HIPAA regulations.
• Support continuous improvement of service quality by meeting performance metrics and adapting to evolving processes and feedback.

Requirements:

• High School Diploma or GED required.
• Minimum of 2 years of customer service experience in a related field.
• Experience in high-volume call center environments with inbound and outbound interactions.
• Strong ability to de-escalate customer concerns with empathy, professionalism, and clear communication.
• Proficiency in Microsoft Office Suite or similar tools, with the ability to navigate multiple systems simultaneously.
• Ability to adapt communication style for diverse audiences, including members and healthcare professionals.
• Strong attention to detail and ability to work with sensitive and confidential information.
• Experience in healthcare, insurance, or claims processing environments is highly valued.
• Ability to accept feedback and adjust performance in a structured, metrics-driven environment.
• Strong organizational skills with the ability to manage multiple tasks and shifting priorities.

Benefits:

• Competitive salary range: $38,500 – $57,800.
• Comprehensive medical, dental, and vision insurance coverage with low employee premiums.
• Retirement benefits including 401(k) with employer match and pension plan.
• Generous paid time off, holidays, and additional floating days.
• Paid training program with 12 weeks of structured virtual onboarding.
• Tuition assistance for undergraduate and graduate education.
• Wellness programs, mental health resources, and employee assistance support.
• Remote work flexibility with structured schedules and full-time stability.
• Employee recognition programs and career development pathways.
• Additional financial, life, and disability insurance benefits.

How Jobgether works:

We use an AI-powered matching process to ensure your application is reviewed quickly, objectively, and fairly against the role's core requirements. Our system identifies the top-fitting candidates, and this shortlist is then shared directly with the hiring company. The final decision and next steps (interviews, assessments) are managed by their internal team.

We appreciate your interest and wish you the best!

Data Privacy Notice: By submitting your application, you acknowledge that Jobgether will process your personal data to evaluate your candidacy and share relevant information with the hiring employer. This processing is based on legitimate interest and pre-contractual measures under applicable data protection laws (including GDPR). You may exercise your rights (access, rectification, erasure, objection) at any time.

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We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.