Customer Service Representative

Customer Service Representative Overview

• The Customer Service Representative will support medical benefits operations in a hybrid work environment.
• Collaborate with internal and external teams to resolve benefit-related issues efficiently.
• Contribute to the development of internal resources and training materials for operational improvement.
• Utilize systems to perform edits and manage data with high attention to detail.
• Ensure compliance with service level agreements while addressing customer inquiries.
• Support mission-driven initiatives impacting customer benefits directly.
• Adapt to a dynamic schedule requiring in-office presence two days per week.
• Engage in cross-functional collaboration to optimize benefit program operations.
• Participate in a structured interview process to demonstrate competency and alignment with organizational values.

Customer Service Representative Key Responsibilities & Duties

• Perform day-to-day operations for medical benefits programs, ensuring accuracy and efficiency.
• Identify and escalate issues impacting benefits, collaborating with stakeholders for resolution.
• Resolve member eligibility and benefit issues adhering to service level agreements.
• Review recurring error reports and partner with stakeholders for corrective actions.
• Develop and maintain internal resources such as help articles and training materials.
• Collaborate with internal teams to improve systems and resolve inquiries efficiently.
• Communicate with third-party partners to address escalated issues and system improvements.
• Provide streamlined operational support to customers and internal teams.
• Adapt to dynamic workflows and contribute to organizational needs as required.

Customer Service Representative Job Requirements

• Bachelor of Science (BS) degree required for consideration.
• Minimum of 1 year of experience in customer service or related field; 2 years preferred.
• Knowledge of employer-sponsored benefit plans and insurance operations preferred.
• Proficiency in Excel or equivalent software; SQL knowledge is a plus.
• Strong written and verbal communication skills for effective collaboration.
• Detail-oriented with the ability to manage complex data and systems accurately.
• Experience in a fast-paced, data-driven environment is highly valued.
• Technologically savvy and process-driven for operational efficiency.
• Ability to work collaboratively within a team to achieve organizational goals.