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Provalus

CX Analyst

Career Insights for Healthcare Customer Service Representative

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Based on Texas data

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What they do

A Healthcare Customer Service Representative responds to customer inquiries about healthcare and provides information about healthcare plans, providers, policies and coverage. Assists customers with questions about healthcare insurance and premiums. Keeps records of customer communications and transactions.

$37,234 / year median in Texas

-8% projected decline

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Job Description

Location:
Onsite Schedule:
Monday-Friday, 8:00 AM-5:00 PM Position Summary We are seeking a Bilingual Customer Service Analyst to provide exceptional support to patients through a high-volume contact center environment. This role is responsible for assisting callers with healthcare-related inquiries, verifying member information, reading required disclosures, and helping patients locate doctors and pharmacies based on their zip code. The ideal candidate is customer-focused, detail-oriented, and comfortable navigating multiple systems, including Salesforce. This position consists of approximately 90% inbound calls and 10% outbound calls . Key Responsibilities Handle a high volume of inbound customer service calls from patients and members. Conduct outbound calls as needed for follow-up and resolution purposes. Verify patient and member information accurately while adhering to compliance requirements. Read required disclaimers and scripted communications when applicable. Assist patients in locating participating physicians, specialists, and pharmacies using zip code-based searches. Document all customer interactions, inquiries, and resolutions within Salesforce. Research and resolve customer issues while maintaining professionalism and empathy. Maintain confidentiality of sensitive patient information and comply with HIPAA guidelines. Meet quality, productivity, and attendance expectations. Collaborate with team members and leadership to ensure a positive customer experience. Qualifications Required Qualifications Bilingual proficiency (English and Spanish preferred). High school diploma or GED required. Minimum of 1 year of customer service, call center, healthcare support, or related experience. Strong verbal and written communication skills. Experience using computer systems and navigating multiple applications simultaneously. Ability to accurately verify and document customer information. Strong attention to detail and problem-solving abilities. Ability to work in a structured, fast-paced environment.