Representative, Support Center II (Remote)

This is a Fully Remote Job About Our Client:The organization operates within the healthcare sector, focusing on providing support and services related to Medicaid, Medicare, and Marketplace lines of business. It addresses challenges in healthcare member and provider engagement by offering multi-channel support and aiming to improve experiences through quality improvement initiatives. About the Opportunity:The REPRESENTATIVE, SUPPORT CENTER II role is responsible for delivering level II customer service support to members and providers. This position is key in resolving inquiries effectively, improving engagement and retention, and supporting continuous quality improvement. The role involves multi-channel communication and collaboration with internal and external stakeholders to address member and provider needs. Responsibilities:Provide service support via phone, chat, email, and other administrative duties.Address member/provider issues including appeals, grievances, and problem resolution.Assist with process improvement and retention efforts.Deliver excellent customer service and achieve first call resolution.Accurately document all interactions.Adhere to scheduled shifts and accommodate overtime as needed.Build rapport and respond empathetically to customer needs.Listen attentively and resolve inquiries effectively.Meet or exceed performance goals related to call quality, attendance, and adherence.Engage proactively with various stakeholders.Take ownership of solutions and follow-ups.Support inquiries involving benefits, claims, premiums, and eligibility.Evaluate risk and escalate issues appropriately.Demonstrate proficiency in multiple lines of business.Manage multiple communication channels promptly.Understand provider service inquiries related to claims and authorizations. Requirements:Minimum of 1 year customer service, call center, or sales experience in a high-volume environment.Strong customer service skills.Experience with data processing.Attention to detail and effective time management.Ability to maintain confidentiality and comply with HIPAA.Ability to build positive work relationships.Effective verbal and written communication skills.Proficiency in Microsoft Office and relevant software. Pay Range and Compensation Package:The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors. 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:TalentHop is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.