Customer Service Representative , Health Plan; Pennsylvania resident

Why consider this job opportunity:

• Opportunity for career advancement and growth within the organization
• Work remotely from anywhere in Pennsylvania
• Comprehensive healthcare benefits available from day one, including vision and dental coverage
• Supportive and collaborative work environment
• Chance to contribute to improving patient and member satisfaction

• Resolve and reconcile enrollment reports and eligibility issues following policy and state guidelines
• Initiate communication and provide literature to newly enrolled Health Plan members and employer groups
• Prepare and disseminate letter communications regarding enrollment activity to subscribers and members
• Review and resolve suspended claims by applying current policies and benefits
• Provide daily support and advice to member and provider services staff regarding claims issues

• High School Diploma or Equivalent (GED) is required
• Minimum of 1 year of experience in Customer Service
• Strong communication skills and knowledge of customer support policies
• Ability to interpret rules and regulations in contractual agreements
• Familiarity with membership data management and reporting tools

• Experience in healthcare customer service or claims processing
• Demonstrated ability to work collaboratively within a team environment
• Knowledge of enrollment processes and eligibility guidelines
• Skills in data analysis and handling complex customer inquiries

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We are not the EOR (Employer of Record) for this position. Our role in this specific opportunity is to connect outstanding candidates with a top-tier employer.