Customer Service Representative (Premium Healthcare Account)

We're looking for experienced and service-driven Customer Service Representatives with a strong background in the US healthcare industry. This role requires the ability to handle complex benefit inquiries, resolve claims issues, and support members through various healthcare needs with professionalism and empathy.

Candidates must demonstrate excellent communication skills, critical thinking, and the ability to manage detailed, sensitive conversations in a fast-paced contact center environment. A background in healthcare-related customer service is essential.

Responsibilities

Handle inbound and outbound calls from health plan members.

Educate members on their US health plan benefits and services.

Investigate and resolve member concerns, escalations, and complaints.

Take ownership of inquiries and provide timely, accurate resolutions.

Communicate complex benefit information clearly and with empathy.

Document interactions and follow up as needed.

Serve as a liaison between customers, providers, and service teams.

Navigate internal tools to provide solutions independently.

Adapt to changes in systems, policies, and procedures.

Demonstrate strong organizational skills and timely communication.

Qualifications

Education & Experience :

College graduate with at least 1 year of BPO experience (healthcare account preferred).

Associate's degree holder with at least 1 year of healthcare experience in a contact center.

Senior High School graduate with at least 2 years of healthcare BPO experience.

Skills :

Strong verbal and written English communication skills.

Proven ability to manage member concerns with empathy and efficiency.

Familiarity with US healthcare systems, CSAT, and NPS.

Proficient in Microsoft Office applications, especially Outlook and Word.

Excellent problem-solving, active listening, and organizational skills.

Ability to work independently in a fast-paced environment.

If you are passionate about helping others and have the qualifications and experience to support members in navigating their healthcare needs, we encourage you to apply.