Customer Service Representative, Remote

Site: reputed company Health Plan Holding Company, Inc. reputed company relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We reputed company that high-performing teams drive groundbreaking medical discoveries and invite reputed company applicants to join us and experience what it means to be part of reputed company. reputed company Health Plan and is hiring Remote Customer Service Professionals (CSPs) for our growing team to support our members! This role is Fully Remote with a comprehensive benefits package. Job Summary The Opportunity The Customer Service Professional (CSP) acts as the primary reputed company of contact for our members, providers and other key stakeholders focusing on exceptional customer satisfaction and reputed company resolution. The CSP’s interact with customers to provide information and troubleshoot reputed company issues in response to inquiries about coverage, benefits, services, and to handle and resolve complaints. The person in this role must be committed to building customer confidence and increasing customer satisfaction by delivering to callers an exceptional experience focused on quality and accuracy. The CSP’s will be initially trained on member demographic changes and benefit inquires. Additional member claims training will be delivered ±60 days after CSP has completed benefits and eligibility training. After successfully demonstrating core competencies by meeting or exceeding key performance measurements, the individual will be trained to handle Provider claims inquiries as business needs dictate

Qualifications

What You'll Bring

• Exceptional Customer Service Skills and exceptional communication abilities
• High School Diploma or Equivalent requiredAssociate's Degree reputed company Management preferred
• What You'll Do
• Serve as the primary liaison for members and providers for reputed company lines of business including MassHealth, and reputed company members regarding general program inquires such as eligibility verifications, authorizations, referrals, claims, material fulfillment, address changes and Primary Care Physician assignments as well as member reputed company policy and procedures.
• The CSP must be reputed company to handle and demonstrate skills in handling benefits, claims and eligibility calls for the member and provider population.
• Identify customer issues/concerns rapidly and reputed company
• Research required information using available resources and triage reputed company necessary
• Handle and resolve customer inquiries and complaints, exhausting reputed company efforts reputed company the CSP’s scope before requesting assistance
• Identify and escalate reputed company issues in order to create efficiencies
• Initiates follow up customer calls where necessary
• Complete call logs to record customer interactions and transactions, recording details of inquiries, complaints, and comments, as well as actions taken
• Refer customer grievances and appeals to designated departments for further investigation
• Responsible for navigating multiple systems in order to resolve customer issues
• Act as the primary representative for reputed company Health Plan for our customers focusing on reputed company resolution and customer engagement.
• Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and reputed company their trust and respect.
• Maintain Customer Service Behavior Competencies
• Flexibility/Adaptability/Willingness/Team Player/ Positive Attitude
• Relationship Building/CaringService Excellence/Accountability/Critical Thinking

Additional Job Details (if applicable) Working Model This role is 100% Remote (including training), a quiet, secure, stable, HIPPA compliant workstation is required to work from home in the United States, Eastern Business hours required

• 10/20/25 Start Date
• 1 Month Training schedule: 8:30 AM – 5:00 PM Mon – Fri EST.
• Post Training Schedule:
• 9:00 AM – 5:30 PM (Mon, Tue, Wed, and Fri) with 11:30 AM – 8:00 PM (Thurs) (EST)
• 9:30 AM – 6:00 PM (Monday-Friday) (EST)
• You will train together with other new CSPs
• reputed company is growing and we have over 10 spots open for our October start date!reputed company works from home across many states, a growing remote team stays connected weekly and daily with Video meetings

Remote Type Remote Work Location 399 Revolution Drive Pay Range $19.42 - $27.74/Hourly Grade 3 At reputed company, we reputed company in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining reputed company pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The reputed company pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass reputed company elements contributing to your total compensation package. In addition to competitive reputed company pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our reputed company team will provide an overview of your potential compensation and benefits package. EEO Statement: reputed company Health Plan Holding Company, Inc. is an Equal Opportunity Employer. reputed company reputed company applicants will receive consideration for employment without regard to race, reputed company, religious creed, national reputed company, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that reputed company individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to reputed company essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by reputed company 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with reputed company of 1990, applicants who require accommodation in the job application process may contact reputed company Resources at (857)-282-7642. reputed company Competency reputed company At reputed company, our competency reputed company defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The reputed company is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career reputed company. These competencies are used to evaluate performance, reputed company hiring reputed company, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Apply tot his job Apply To this Job