{"schemaVersion":"jobsearcher.job.v1","id":"20d2dc0ae644e1a8edd7381d","url":"https://jobsearcher.com/jobs/20d2dc0ae644e1a8edd7381d","canonicalUrl":"https://jobsearcher.com/jobs/20d2dc0ae644e1a8edd7381d","title":"Remote Call Center Associate","description":"We are hiring for remote customer service associates. Must be in PA, DE, VA, or MDRole OverviewCustomer Service Representatives (CSRs) serve as the primary point of contact for members and healthcare providers.Key duties include handling inquiries, explaining eligibility and benefits, and resolving customer or provider issues with accuracy and efficiency.Culture focuses on collaboration, continuous learning, recognition, and delivering better health outcomes.Job ResponsibilitiesAnswer and manage inbound inquiries regarding plan benefits, claims, eligibility, procedures, billing, and payments in a prompt, courteous manner.Conduct outbound and return calls to customers as needed.Accurately document all customer interactions and transactions in the company CRM system.Actively listen and ask targeted questions to identify customer needs while logging concise notes in computer systems.Communicate empathetically, translating complex healthcare jargon into clear, step-by-step instructions.Process customer complaints and grievances using conflict management skills to de-escalate stressful situations.Meet establish performance goals across efficiency, accuracy, quality, member satisfaction, and attendance.Adhere strictly to department, organizational, and regulatory policies and procedures.Comprehend and verbalize organizational processes, procedures, and health insurance coverage details.Qualifications & ExperienceCustomer Service Experience: At least 1–2 years in a customer service role, preferably within a healthcare setting.Call Center Experience: At least 1 year in a call center managing high-volume inbound calls.Healthcare Knowledge: Familiarity with medical terminology, health plan benefits, patient eligibility, and medical policy exclusions.Language Skills: Bilingual proficiency in Spanish and English is a plus (validated via assessment upon offer acceptance).Program Knowledge: Familiarity with Managed Care, Commercial, Marketplace, Medicaid, or Medicare programs is a plus.Skills & Core CompetenciesCommunication & Interpersonal: Excellent communication, empathy, negotiation, and conflict resolution skills to build trust with members and providers.Computer Skills: Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint).Technical Proficiency: Ability to navigate multiple software systems simultaneously, including CRM tools and email platforms.Performance Focus: Customer-focused, detail-oriented, and efficient in a fast-paced environment.Compliance: Adherence to healthcare laws and regulations, particularly regarding patient confidentiality and rights.","company":"Unkown","rawCompany":"unkown","isRemote":true,"isActive":false,"createdAt":"2026-08-07T08:15:30.683Z","occupations":[{"code":"43-4051.00","title":"Customer Service Representatives","slug":"customer-service-representatives"},{"code":"29-2099.08","title":"Patient Representatives","slug":"patient-representatives"},{"code":"43-4171.00","title":"Receptionists and Information Clerks","slug":"receptionists-and-information-clerks"}],"industries":[{"code":"561422","title":"Telemarketing Bureaus and Other Contact Centers","slug":"telemarketing-bureaus-and-other-contact-centers"},{"code":"561421","title":"Telephone Answering Services","slug":"telephone-answering-services"},{"code":"524114","title":"Direct Health and Medical Insurance Carriers","slug":"direct-health-and-medical-insurance-carriers"}],"jobPosting":{"@context":"https://schema.org","@type":"JobPosting","title":"Remote Call Center Associate","description":"We are hiring for remote customer service associates. Must be in PA, DE, VA, or MDRole OverviewCustomer Service Representatives (CSRs) serve as the primary point of contact for members and healthcare providers.Key duties include handling inquiries, explaining eligibility and benefits, and resolving customer or provider issues with accuracy and efficiency.Culture focuses on collaboration, continuous learning, recognition, and delivering better health outcomes.Job ResponsibilitiesAnswer and manage inbound inquiries regarding plan benefits, claims, eligibility, procedures, billing, and payments in a prompt, courteous manner.Conduct outbound and return calls to customers as needed.Accurately document all customer interactions and transactions in the company CRM system.Actively listen and ask targeted questions to identify customer needs while logging concise notes in computer systems.Communicate empathetically, translating complex healthcare jargon into clear, step-by-step instructions.Process customer complaints and grievances using conflict management skills to de-escalate stressful situations.Meet establish performance goals across efficiency, accuracy, quality, member satisfaction, and attendance.Adhere strictly to department, organizational, and regulatory policies and procedures.Comprehend and verbalize organizational processes, procedures, and health insurance coverage details.Qualifications & ExperienceCustomer Service Experience: At least 1–2 years in a customer service role, preferably within a healthcare setting.Call Center Experience: At least 1 year in a call center managing high-volume inbound calls.Healthcare Knowledge: Familiarity with medical terminology, health plan benefits, patient eligibility, and medical policy exclusions.Language Skills: Bilingual proficiency in Spanish and English is a plus (validated via assessment upon offer acceptance).Program Knowledge: Familiarity with Managed Care, Commercial, Marketplace, Medicaid, or Medicare programs is a plus.Skills & Core CompetenciesCommunication & Interpersonal: Excellent communication, empathy, negotiation, and conflict resolution skills to build trust with members and providers.Computer Skills: Proficiency in Microsoft Office (Word, Excel, Outlook, PowerPoint).Technical Proficiency: Ability to navigate multiple software systems simultaneously, including CRM tools and email platforms.Performance Focus: Customer-focused, detail-oriented, and efficient in a fast-paced environment.Compliance: Adherence to healthcare laws and regulations, particularly regarding patient confidentiality and rights.","datePosted":"2026-08-07T08:15:30.683Z","dateModified":"2026-08-07T08:15:30.683Z","hiringOrganization":{"@type":"Organization","name":"Unkown","sameAs":"https://jobsearcher.com"},"jobLocationType":"TELECOMMUTE","applicantLocationRequirements":{"@type":"Country","name":"US"},"identifier":{"@type":"PropertyValue","name":"JobSearcher","value":"20d2dc0ae644e1a8edd7381d"},"url":"https://jobsearcher.com/jobs/20d2dc0ae644e1a8edd7381d"}}