Customer Service Representative

We are looking for an experienced and customer-focused Customer Service Representative to join our team in Troy, Michigan. This role involves working in a fast-paced, high-volume call center environment, primarily supporting healthcare-related inquiries. As a Contract to permanent position, this opportunity offers the potential for long-term career growth, making it ideal for candidates who thrive in dynamic and collaborative settings. The role is primarily remote, though occasional in-office work may be required.

Responsibilities:

• Respond to customer inquiries via phone and email with professionalism and accuracy.
• Provide detailed information about healthcare benefits, claims, and pre-authorizations.
• Troubleshoot and resolve customer issues, ensuring a high level of satisfaction.
• Document all interactions and updates in the system promptly and accurately.
• Stay informed about changes to healthcare plans and policies to provide up-to-date information.
• Direct unresolved queries to supervisors or relevant departments as needed.
• Assist customers with outstanding payments and explain billing details when necessary.
• Offer guidance and information about network providers to current and prospective members.
• Adhere to HIPAA regulations and maintain the confidentiality of sensitive information.
• Use critical thinking skills to handle complex situations effectively and independently.