Provider Customer Service Representative (Health Insurance)

Location: Remote within the United States; San Antonio, TX is listed. Must be a US resident authorized to work in the US. Schedule: Monday–Friday, 8 AM–5 PM EST.

Salary: $16 per hour.

Company

Customer support services are provided for a health insurance company customer.

What you will do

• Handle claims status inquiries, denial rationales, appeals, medical records, research, routing, and EOB/EOP requests.
• Support authorization and utilization management inquiries, including prior authorization verification and appeals.
• Verify provider participation, eligibility, coverage, benefit grids, and credentialing information.
• Document calls thoroughly, explain next steps, resolve provider issues, and manage back-to-back calls.
• Educate providers on self-service tools such as Availity.

Requirements

• High school diploma or equivalent.
• 1–2 years of high-volume call center experience.
• Typing speed of 35–40 WPM, strong written and verbal communication, active listening, problem-solving, and multitasking skills.
• Dedicated quiet workspace, reliable schedule adherence, and internet speeds of at least 10 Mbps download and 2 Mbps upload.
• US residency and authorization to work in the United States are required.

Nice to have

• 1–2 years of experience in a medical office, healthcare insurance, billing and coding, or back-end processing.

Culture & Benefits

• Paid training with a dedicated trainer.
• Medical, dental, and vision benefits.
• Flexible vacation available after training.
• Company-provided equipment and employee assistance and wellness resources.
• Employee discounts and an 80% internal promotion rate.