Customer Service Call Center Representative

Job Description

Key Responsibilities

Respond to inbound calls and emails regarding employee benefits, including plan details, eligibility, coverage, claims, and enrollment.

Assist members with navigating online portals or completing forms related to benefit elections and changes.

Educate callers on benefits, deadlines, and regulatory notices (e.g., COBRA, HIPAA, ACA).

Troubleshoot and resolve issues related to claims processing, benefit cards and logging into portal.

Maintain up-to-date knowledge of company-sponsored benefit plans and compliance regulations.

Accurately document all interactions in Salesforce the customer relationship management system.

Escalate complex or urgent matters to appropriate internal teams, broker or employer contact.

Adhere to privacy and confidentiality standards, including HIPAA and PHI compliance.

Qualifications

High school diploma or equivalent required; associate or bachelor’s degree preferred.

1+ year of call center or customer service experience, preferably in benefits, insurance, or healthcare.

Familiarity with benefit terminology (e.g., PPO, HMO, FSA, 401(k)) and processes is strongly preferred.

Strong communication, problem-solving, and time management skills.

Proficient with computer systems and customer databases; ability to learn proprietary systems quickly.

Must maintain a high level of professionalism and confidentiality.

Full-time

Fully remote