Remote Healthcare Customer Service Representative (11:30am - 8pm EST)

About the role

The Phia Group provides claim recovery services for health benefit plans. When a health benefit plan pays medical bills and another party should have paid those bills, The Phia Group, on behalf of the health plan, seeks to recover the funds. The ideal Customer Service Representative will present a service‑driven mindset and strive for excellence in interactions. Work includes answering calls and written inquiries from clients, insureds, attorneys, and adjusters, collecting accident details to determine potential sources of recovery and promoting or demoting cases accordingly. The Phia Group’s mission is to provide high‑quality yet affordable healthcare to American employees and their families, offering exceptional benefits and a workplace recognized as one of USA Today’s Top Workplaces for 2026 and listed by The Boston Globe, Courier Journal, and Louisville Business First as a Top Place to Work.

Responsibilities

• Manage high-volume customer inquiries through phone calls, voicemails, faxes, scanned correspondence, and emails.
• Identify and assess customer needs to achieve maximum client satisfaction.
• Assist callers in real-time with data collection or education; transfer/redirect calls to the appropriate Recovery Specialists when appropriate.
• Utilize internal systems and resources to provide accurate, valid and complete information relevant to the situation.
• Ensure adequate phone coverage with regular attendance and use of situational awareness during scheduled shift to minimize missed and abandoned calls.
• Review, promote, and activate both client & Phia generated referrals that result from Call Center activity.
• Collection and documentation of handling attorney and/or adjuster information to the appropriate tabs in the system along with any additional pertinent information, as-needed.
• Ensure all calls and/or case activations, data entry, and data management are handled within company guidelines.
• Maintain and respond to department requests submitted through the online questionnaire portal.
• Maintain and research automatic updates generated through a national database used to identify third party claims.
• Perform reviews of scanned documentation for systematic update such as Phia Accident Questionnaires.
• Generate client specific reports on a weekly basis, as-needed.
• Responsible for protecting company assets from unauthorized access, disclosure and/or modification; as well as comply with the organization's information security policies.

Qualifications

• 2+ years of experience in one of the following areas: Law Firm, Insurance Company, Third Party Administrator (TPA) or Medical Field
• Call center experience
• Located in MST or PST preferred
• High School diploma or equivalent preferred
• Bilingual preferred, but not required
• Remote work or education experience
• Private workspace with closed off door for privacy
• Sufficient internet speed to support video, IP phone, and multi-system usage
• No distractions in home that would require assistance during working hours
• Strong verbal and written communication skills
• Knowledge of good telephone etiquette, soft skills, and emotional intelligence
• Effective listening skills
• Mastery of time management and organization with ability to pivot from task to task
• Excellent attention to detail and documentation
• Outstanding organizational, interpersonal, and administrative skills
• Must have the ability to work as part of a team, as well as to work independently
• Must be self-motivated and able to meet deadlines under pressure

Pay

$47,000 per year base salary.

Schedule

Fully remote position; during the first four weeks of training you must be able to work an earlier shift.