Responsibilities
- Deliver sincere, empathetic, accurate, and efficient service during every interaction
- Handle high-volume inbound calls, emails, written correspondence, and walk-in inquiries
- Explain benefit provisions, claim payments, and claim denials clearly and professionally
- Verify eligibility and benefits; research and resolve claim or eligibility discrepancies
- Quote self-payment amounts and update eligibility with outside vendors
- Accurately document all participant interactions within the customer service system
- Navigate eligibility systems, claim payment systems, and reciprocity platforms
- Monitor call queues and manage messages through the call management system
- Perform clerical tasks such as processing enrollment forms and related documentation
- Escalate complex concerns to appropriate leadership for resolution
- Participate in special projects and additional duties as assigned
Qualifications
- 1+ year of customer service experience required (call center experience strongly preferred)
- Experience in banking, unions, employee benefits, healthcare, or related structured service environments highly desirable
- Minimum typing speed of 40 WPM
- High School Diploma required
- Proficiency in Microsoft Office (Word, Excel, Outlook)
- Strong written and verbal communication skills
- Demonstrated initiative, empathy, professionalism, and problem-solving ability
- Ability to troubleshoot issues, gather documentation, and collaborate across departments