Call Center Representative

Position Summary
We are seeking a dedicated and compassionate Call Center Representative to join our team. In this role, you will deliver a high-quality service experience by providing accurate, empathetic, and efficient support to participants and external partners. You will serve as a key point of contact, ensuring every interaction is handled with professionalism, courtesy, and care.

Key Responsibilities
Develop and maintain a strong working knowledge of benefit plan provisions, eligibility requirements, and claims processes
Respond promptly and accurately to incoming phone calls, emails, written correspondence, and in-person inquiries
Explain claim payments, clarify denials, verify eligibility and benefits, and quote applicable payment amounts
Research and resolve eligibility or claim-related issues in collaboration with internal teams and external vendors
Escalate complex participant concerns to appropriate team members for resolution
Accurately document all interactions within the customer service system
Process enrollment forms and other related documentation
Navigate internal and external systems to provide accurate website and plan information
Monitor and manage inbound call queues and voicemail systems
Assist with special projects and additional administrative tasks as assigned

Qualifications
Minimum of 1 year of customer service experience
High School Diploma or equivalent required
Typing proficiency of at least 40 words per minute
Proficiency in Microsoft Office applications
Strong written and verbal communication skills
Demonstrated initiative, dependability, and commitment to service excellence

Preferred Attributes
Ability to manage multiple priorities in a fast-paced environment
Strong problem-solving and investigative skills
Demonstrates empathy, patience, and professionalism in all interactions
Ability to collaborate effectively with internal departments, vendors, and stakeholders
Consistent attendance and reliability