Customer Service Representative

Job Description:

Under the direct supervision of Operation Supervisors, the Customer Service Representative is responsible for supporting a diverse membership community and their providers as well as other customers in a timely manner. This includes inbound and outbound engagement with members and/or providers via phone calls or correspondence regarding benefits, eligibility, or customer issues.

Responsibilities:

• Conduct Welcome Calls to new members and perform Health Assessment Surveys as needed.

• Provide member education and assists members with Primary Care Physician (PCP) selection and assignments.

• Assist with access to care and wellness programs.

• Demonstrate passion for providing superior customer service to our members and continually seek to understand the needs of those we serve.

• Follow internal processes and procedures to ensure all activities are performed in accordance with departmental and company policies and procedures.

• Create accurate and timely documentation concerning all inquiries taken in accordance with established protocols to ensure resolution is provided and presented in a clear and accurate manner.

• Present and project a positive image of the company in and out of the office to fellow associates, members, providers and the community by being courteous, helpful, energetic, respectful and polite.

• Strive to resolve an inquiry on first contact while ensuring that the inquiries have been addressed to the customer's satisfaction by using all resources in an efficient and timely manner.

• Provide feedback and/or solutions to supervisor to ensure continuous process improvement and provide better customer experience.

• Create and support an environment which fosters teamwork, cooperation, respect and diversity.

• Maintain an awareness of all product knowledge information.

• Able to respond positively to support change within the department and the company.

• Routinely meet or exceed contact center key performance indicators.

• Perform other duties as assigned.

Training Information:

• Training is conducted onsite Monday through Friday from 8:30 AM - 5:00 PM and lasts approximately 6-7 weeks (maximum) . During this period, you are required to be fully available and onsite for the entire duration of training .

• Upon successful completion of training, the role will transition to a remote work environment . However, you may be required to report to a business office for mandatory meetings and/or technical support related to remote work .

Work Schedule:

• Our Contact Center operates 24 hours a day , and this position requires flexibility to work shifts between 7:00 AM - 7:00 PM . Start times will vary, typically ranging from 7:00 AM to 10:30 AM , and are assigned based on business needs (example shift: 10:30 AM - 7:00 PM ).

• Your permanent schedule will be assigned toward the end of training and will remain consistent based on operational needs.

Education & Experience requirements:

• High School Diploma or GED.

• 1-year of prior customer service experience.

• Experience in the healthcare or managed care industry is preferred but required.

• Proficiency in PC applications within a Microsoft Windows environment.

• Demonstrated verbal and written communication skills combined with listening and problem-solving ability to identify needs, seek solutions and resolve customers' concerns.

• Ability to work well in a team environment and willingness to learn and adopt customer service methods and practices.

Our Comprehensive Benefits Package

Flexible work solutions include remote options, hybrid work schedules, competitive pay, paid time off, holidays and volunteer events, health insurance coverage for you and your dependents starting Day 1, 401(k) retirement savings plan, tuition reimbursement, and more.

Why Join Us: Your career starts now. We are looking for the next generation of healthcare leaders. At AmeriHealth Caritas, we are passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together, we can build healthier communities. If you are driven to make a difference, we want to hear from you.

About AmeriHealth Caritas

Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with over 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. Our services include integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at

As a company, we support internal diversity through:

Recruiting. We are an equal opportunity employer. We do not discriminate on the basis of age, race, ethnicity, gender, religion, sexual orientation, or disability. Our inclusive, equitable approach to recruiting and hiring reinforces our commitment to DEI.