Customer Service Representative

Location: Maryland area, United States

Company

hirify.global provides customer service professionals to support a healthcare insurance client.

What you will do

• Answer member, provider, and broker inquiries about product information, benefits, claims, eligibility, and billing.
• Research claim submissions, verify claim and system accuracy, assess liability, and provide first-level problem resolution.
• Interpret contractual provisions, benefit utilization rules, and service limitations for customers.
• Provide information about health, financial, managed care, and self-service programs.
• Offer basic technical assistance for digital and electronic applications and participate in claims adjustments when applicable.
• Document client interactions, maintain advocate records, update account information, and manage high-volume workflows.

Requirements

• High school diploma or equivalent G.E.D.
• At least 3 years of high-volume inbound call center or customer service support experience, handling approximately 70 or more calls per day.
• Required experience in health payer insurance, including knowledge of Medicare and/or Medicaid.
• Technical proficiency with Microsoft Office, including Outlook, Excel, and Word, and the ability to participate in meetings through Microsoft Teams.
• Ability to work in a quality- and production-driven environment, multitask efficiently, and provide accurate information.
• Ability to defuse irate customers by phone and demonstrate strong attention to detail.

Nice to have

• Outbound calling experience.
• Knowledge of CPT, HCPCS, and ICD-9/ICD-10 codes.
• Knowledge of PHI member data.