Overview
Claims Customer Service Representative Jobs in United States at RemoteHunter
Title: Claims Customer Service Representative
Company: RemoteHunter
Location: United States
1. About Our Client:
The organization operates within the healthcare industry, addressing challenges in connecting people with care, pharmacy benefits, and health resources. It uses technology to support millions of individuals in improving health outcomes. The program focuses on advancing health optimization through inclusive culture, skilled teams, and broad-reaching services that impact communities on a global scale.
2. About the Opportunity:
The Claims Customer Service Representative will provide compassionate, high-quality support to callers by resolving inquiries related to healthcare eligibility, claims, and payments. This role directly impacts customer experience by delivering clear guidance and solutions, helping members navigate complex systems. The position requires managing 30 to 40 calls daily, ensuring each interaction improves the customer’s experience and satisfaction.
3. Responsibilities:
• Answer incoming calls from members, providers, and facilities regarding benefits, eligibility, billing, authorizations, and claims
• Resolve issues on the first call by navigating multiple computer systems
• Provide accurate information and build strong relationships with callers
• Actively listen and document information in computer systems
• Research complex issues using multiple databases and collaborate to resolve escalated concerns
• Meet performance goals for efficiency, call quality, customer satisfaction, and attendance
4. Requirements:
• High School Diploma or GED
• At least 18 years old
• Minimum 1 year experience in call center, customer service, or related environment using phones and computers
• Proficiency with Windows PC applications and ability to learn complex systems
• Successful completion of customer service training and demonstration of proficiency
• Ability to work full time Monday to Friday with flexible 8-hour shifts between 8:00 am and 5:00 pm CST, including occasional overtime
Preferred:
• Experience in healthcare
• Call center experience
Telecommuting:
• Residence in Minnesota, Iowa, North Dakota, South Dakota, or Wisconsin
• Secure handling of sensitive documents if applicable
• Dedicated, private workspace at home
• Access to an approved high-speed internet connection
Soft Skills:
• Ability to multitask and understand multiple products and benefits
• Strong listening, communication, empathy, and rapport-building skills
• Critical thinking to resolve customer issues
5. Pay Range and Compensation Package:
• Hourly pay ranges from $16.15 to $28.80 based on experience and employment status
• Additional benefits include a comprehensive package, incentive and recognition programs, equity stock purchase, and 401k contributions (subject to eligibility)
• Pay is influenced by local labor markets, education, work experience, and certifications
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
RemoteHunter is not the Employer of Record (EOR) for this role. Our purpose in this opportunity is to connect exceptional candidates with leading employers. We help job seekers worldwide discover roles that match their goals and guide them to complete their full application directly through the hiring company’s career page or ATS.
