Call Center Representative

About the Role Are you a people-focused customer service professional who enjoys helping others, solving problems, and making complicated information easier to understand? We’re looking for a Call Center Representative. In this role, you’ll serve as a trusted resource for participants navigating their health benefits, answering questions, resolving concerns, and helping people understand the processes and resources available to them. This is more than a traditional customer service position. You’ll have the opportunity to build expertise in health benefits and insurance while developing strong communication, problem-solving, and client-service skills. Comprehensive training and support will be provided—you don’t need to be a benefits expert on day one. Responsibilities Provide friendly, professional, and empathetic customer service by phone, email, in person, and through written correspondence Handle a high volume of participant calls while maintaining accuracy, professionalism, and a positive attitude Answer questions regarding eligibility, health benefits, claims, self-payments, and other plan-related matters Research participant questions and concerns to identify accurate answers and effective solutions Explain claim payments and help participants understand why a claim may have been denied Verify participant eligibility and benefits and coordinate updates with outside vendors Collaborate with internal departments, healthcare providers, vendors, local unions, and employers to resolve participant concerns Learn and apply organizational policies, benefit schedules, eligibility systems, claims systems, and other plan resources Accurately document participant interactions and maintain complete and organized records Assist participants with enrollment forms, working spouse forms, disability claims, special fund claims, and other benefit-related processes Help participants navigate the website and online resources Escalate complex questions or concerns to the appropriate team member when additional assistance is needed Monitor and follow established procedures to ensure accurate and compliant handling of participant requests Participate in special projects and provide support to the Customer Service team as needed Qualifications At least 1 year of phone-based customer service experience required; experience as a Customer Service Representative, Receptionist, Scheduler, Patient Care Coordinator, Claims Representative, or similar role is highly relevant Previous experience in healthcare, health insurance, benefits administration, or a medical environment is strongly preferred High School Diploma or equivalent required; college coursework or a degree is a plus Ability to typeat least 40 words per minute Strong written and verbal communication skills with the ability to explain information clearly and professionally Excellent customer service skills and a genuine desire to help others Strong attention to detail and accuracy, particularly when working with participant information and benefits-related documentation Comfortable handling a high volume of phone calls and working in a structured, rules-oriented environment Strong problem-solving and investigative skills with the ability to research issues and identify appropriate solutions Ability to remain patient, professional, and empathetic when interacting with frustrated or upset participants Strong organizational skills with the ability to manage multiple tasks and priorities Proficiency with Microsoft Office and general computer systems Ability to work independently while also collaborating effectively with a team Dependable and punctual, with a strong commitment to consistent attendance and being prepared to start work on time Comfortable working100% on-site in Rockville, MD Willingness to work a potential schedule of 10:00 AM–7:00 PM Bilingual skills are a plus Full-time, Onsite $26-28hr #J-18808-Ljbffr Rocs, Inc.