Remote Customer Service - Health Industry (Colorado Applicants)
Do you live in Colorado? Are you an experienced Customer Service Representative with a background in high-volume call centers and the health insurance industry? We are seeking dedicated, customer-focused individuals to join our fully remote team! This is a dynamic role where you will be the first point of contact, providing essential support to members and providers regarding coverage, benefits, and claims. Key Details & Compensation • Location: Fully Remote - Colorado Residents Only, Please. (Must be authorized to work in the U.S.) • Work Schedule: Shifts are scheduled within the call center operating hours of Monday – Friday, 6:00 AM – 7:00 PM CST. • Time Zone Requirement: Must be able to work on a Central Standard Time (CST) schedule. • Pay Rate: • * $18.00 per hour (Non-Bilingual) • $18.50 per hour (Bilingual - Spanish highly desired) What You'll Do (Primary Responsibilities) • Resolve complex inquiries from members and healthcare providers via phone, email, web portal, and chat regarding eligibility, benefits, claims payment, and authorizations. • Educate customers and professionals on insurance coverage and the benefits of self-service tools. • Assist members in accessing care by locating network dentists or assigning a primary care dentist. • Analyze patient activity (enrollment, claims, third-party liability) to resolve coordination of benefits and claim payment inquiries. • Thoroughly and completely document all customer interactions across multiple systems. • Take ownership of issue resolution, set clear expectations for follow-up, and appropriately route inquiries beyond the scope of the role. • Meet or exceed individual and department service goals. What You'll Need (Job Requirements) • Education: High School Diploma or Equivalent. • Experience: • * 2 years of experience in a high-volume customer service/call center environment. • 1 year of experience in the health insurance industry. • Skills: • * Exceptional professional verbal and written communication skills. • Proven ability to utilize multiple software applications simultaneously while managing customer interactions. • Strong critical thinking, problem-solving, and organizational skills with excellent attention to detail. • Ability to work independently, troubleshoot basic technical issues, and adapt quickly in a fast-paced production environment. Preferred Qualifications: Knowledge of medical/dental terminology, Medicare/Medicaid, and claims/billing/coding experience are a plus. Company DescriptionRandstad Staffing. We provide outsourcing, staffing, consulting, and workforce solutions within the areas of engineering, accounting and finance, healthcare, human resources, IT, legal, life sciences, manufacturing and logistics, office and administration, and sales and marketing. We can’t wait to tell you all about it!