Customer Service Representative

4 weeks ago


Troy, United States Michigan Staffing Full time

Medical Customer Service Representative We are looking for a dedicated and detail oriented Medical Customer Service Representative. This role requires exceptional communication skills and the ability to work effectively in a fast-paced, high-volume call center environment, particularly within the healthcare industry. As a contract to permanent position, this opportunity offers the potential for long-term placement based on performance. Responsibilities: Respond promptly and courteously to customer inquiries regarding medical benefits, eligibility, claims, and provider information. Assist customers in resolving pre-authorization requests for medical treatments and provide accurate information about outstanding payments. Document interactions and track call details using internal systems to ensure proper record-keeping. Stay informed about company policies and updates to healthcare plans to provide accurate and current information to customers. Handle complaints, troubleshoot issues, and escalate complex cases to supervisors when necessary. Deliver high-quality service by adhering to scripts and guidelines while maintaining a friendly and detail oriented demeanor. Educate customers about network providers and guide them through available options. Collaborate with team members to improve processes and ensure customer satisfaction. Comply with HIPAA regulations and follow standard precautions for personal protective equipment when required. Requirements: Strong background in call center operations, especially in healthcare-related settings. Familiarity with medical terminology, diagnosis codes, and insurance protocols. Excellent verbal and written communication skills with an ability to handle challenging situations calmly and effectively. Proficient in computer systems and Microsoft Outlook with a fast typing speed. Demonstrated ability to think critically, make sound judgments, and manage stress in high-pressure environments. Availability to work flexible shifts, including evenings, weekends, and holidays. Associate's Degree preferred; alternatively, 1-3 years of healthcare customer service experience in a call center setting is acceptable. Previous experience as a Customer Service Specialist or equivalent role is required.



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