Healthcare Benefits Representative

Job Overview

We are hiring Customer Service Agents to support health benefits and member services in a remote environment. In this role, you will initially support high-volume Open Enrollment activities and transition into ongoing customer service support across multiple channels.

What You’ll Do

• Assist members with Benefits, enrollment, and plan education
• Coverage, claims, billing, and payments
• Provider networks, referrals, and pre-authorizations
• Accurately process enrollments and update member information
• Troubleshoot and resolve customer issues efficiently
• Navigate multiple systems while interacting with customers
• Maintain accurate records in CRM systems
• Ensure compliance with HIPAA and company policies
• Collaborate with internal teams to resolve complex concerns
• Meet performance metrics including quality, productivity, and customer satisfaction
• Stay current on healthcare policies, benefits, and system updates

Schedule

Full-time, 40 hours per week
Flexible availability required, including evenings, weekends, and holidays
Overtime may be available during peak periods

Work Environment

Private, distraction-free workspace (not a shared/common area of the home)
Hard-wired ethernet internet connection with minimum speeds of 50 Mbps download / 10 Mbps upload

Required

• Must be 18 years or older
• High school diploma or equivalent
• At least 1 year of customer service experience (call center preferred)
• Strong verbal and written communication skills
• Basic computer skills (typing, system navigation, multi-tasking)
• Ability to work in a fast-paced, high-volume environment
• Strong problem-solving and decision-making skills
• Reliable attendance and punctuality

Preferred

• Healthcare, insurance, or benefits experience
• Enrollment or claims support experience
• Previous remote work experience

Eligible States

This role is currently limited to candidates residing in Alabama, Arkansas, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Kentucky, Louisiana, Michigan, North Carolina, Ohio, Oklahoma, Pennsylvania, South Carolina, Tennessee, Texas, Virginia, West Virginia, Wisconsin, and Wyoming.