Remote Healthcare Customer Service Representative

Randstad Digital Americas is a leading national healthcare and dental benefits administrator dedicated to improving oral health outcomes. They are seeking a Remote Healthcare Customer Service Representative to serve as a vital liaison for members and healthcare providers, ensuring seamless access to care and resolving complex inquiries.

Responsibilities:

• Serve as a primary point of contact for members and dental professionals, delivering accurate information on eligibility, benefits, authorizations, and claims payments across phone, email, web portal, and chat channels
• Assist members in accessing quality care by locating in-network dentists or coordinating assignments to primary care dental practices
• Resolve coordination of benefits and complex claim payment inquiries by analyzing patient activity, enrollment data, third-party liability, and attachments
• Guide customers and healthcare providers on how to effectively utilize self-service digital tools and resources

Requirements:

• High School Diploma paired with at least 2 years of experience in a high-volume customer service role
• Minimum 1 year of hands-on experience within the health insurance industry
• Skills- Healthcare System Navigation
• Basic Software Skills
• CRM
• Telephone Etiquette