Customer Service Representative

TL;DR

Customer Service Representative (Medical Claims): Interact with customers and providers to provide eligibility and claim information, review plan certificates, and investigate payment issues with an accent on HIPAA compliance and single call resolution. Focus on answering calls, documenting interactions, monitoring voicemails, and educating on plan access technologies.

Location: Remote (US only)

Salary: $14.09 - $16.00 Hourly

Company

hirify.global is part of Arrowhead Intermediaries, a global insurance distribution platform with over 7,000 professionals and $18 billion in premiums placed.

What you will do

• Answer incoming calls, log into assigned phone queues, and provide eligibility/claim info to providers and members.
• Review plan certificates for benefits, limitations, and exclusions; investigate claim payments and PPO processing.
• Document call details, monitor voicemail, respond to status requests, and initiate check inquiries.
• Educate on new technologies, use probing skills for issue resolution, and maintain call standards.
• Understand HIPAA regulations and complete special projects as needed.

Requirements

• Effective time management and ability to work independently within guidelines.
• Excellent interpersonal, oral, and written communication skills.
• Intermediate Microsoft Office skills, problem resolution, multitasking, and organizational abilities.
• Experience with claims/business software and ability to thrive in a fast-paced team environment.

Culture & Benefits

• Exceptional white-glove service focus in medical department.
• Equal opportunity workplace committed to diversity and inclusion.
• Part of a large global platform offering specialization and innovation in insurance.