Group Health Customer Service Representative
About the Opportunity The hiring organization is seeking a motivated Group Health Customer Service Representative for a full-time, remote position based in the United States. This role serves as a key operational liaison among clients, technical teams, and internal operations, coordinating the scheduling and assignment of physician reviewers for referral cases.
Key Responsibilities
Intake incoming cases, verify referral information, and enter case details into the internal operations system. Follow up with clients to resolve missing information necessary for claim processing. Sort, organize, and compile medical document listings in accordance with client specifications and special handling instructions. Monitor, process, and track ongoing cases to ensure established service deadlines are met. Schedule and assign new cases to appropriate reviewing physicians based on reviewer availability, geographic location, client specifications, and jurisdictional guidelines. Confirm that assigned physicians have no conflicts of interest regarding case assignments. Maintain regular client contact by providing timely case status updates and addressing questions regarding referral details. Transmit completed case documentation and records to clients and reviewers as required. Conduct high-volume telephone and email communications with clients, claimants, and physician offices while performing continuous computer-based administrative work.
Required Qualifications
At least 1 year of administrative or clerical experience in a business office environment. Demonstrated computer proficiency and strong organizational skills. Professional written and verbal communication skills, including comfort communicating directly with clients, claimants, and medical providers by phone and email. Ability to maintain strong attention to detail and sustained focus in a fast-paced work setting. Ability to manage multiple tasks and adapt to shifting priorities.
Preferred Qualifications
Associate degree. Prior experience in a healthcare environment, such as a medical office or insurance claims setting. Experience utilizing Apple operating systems, Google Chrome, and Gmail. Work-from-Home Requirements Candidates must supply and maintain their own reliable, uninterrupted high-speed internet service.
Compensation and Benefits
Starting compensation is based on candidate experience, education, and specific qualifications, with eligibility for performance bonuses. Comprehensive benefits package includes health coverage (medical, dental, and vision), paid time off, retirement savings plan with organization match, life and disability insurance, and remote work support. The organization is committed to fair compensation practices and fostering an inclusive workplace.