Job Description:
• Serving as the first point of contact for members and providers, handling 30–40 calls per day while also managing chats, texts, emails, video, and co-browsing, with an expected call resolution time of 6 to 8 minutes.
• Navigating multiple systems and balancing several interactions at once, staying accountable for accurate, timely, and empathetic resolutions.
• Assuring the accurate and timely handling of client and member calls with total follow through.
• Answering client and provider questions including, but not limited to claims payment, status and coverage information.
• Educating customers on their plan and encouraging use of our digital tools—helping them learn how to navigate healthcare more confidently.
• Interpreting client health plan protocol.
• Reviewing claims status and providing status to member. Check tracer documentation.
• Maintaining accurate and complete call documentation.
• Maintaining high level of professionalism.
• Returning incoming calls.
• Solving questions about benefits, claims, eligibility, and providers, collaborating across teams when needed.
• Safeguarding privacy at all times—strictly following HIPAA and confidentiality standards.
• Documenting thoroughly, taking ownership of issues, and following through until every customer feels heard and supported.
Requirements:
• At least 2 years of experience in a healthcare contact center.
• 3+ years of customer service experience overall.
• Associate or Bachelor's degree or recent work toward a degree is preferred.
• Prior experience working across multiple customer service channels such as calls, chat, text, and email.
• Tech-savvy with the ability to learn and pivot quickly across multiple systems.
• Strong communication, listening, and problem-solving skills.
• A calm, professional presence in high-volume situations, with empathy as a core strength.
Benefits:
• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.
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