Customer Service Representative

Point C is a national third-party administrator delivering customized self-funded benefit programs and cost-containment solutions. The Customer Service Representative provides benefit information, claim status updates, and general health plan information while assisting callers, resolving account questions, and coordinating with claim staff. The role is remote after training and operates during business hours in the Eastern Time zone.

Responsibilities:

• Create a welcoming experience by authentically engaging every caller, every time
• Make a connection with customers by engaging in friendly and genuine conversation throughout each call to provide a world-class experience
• Interacting with team and co-workers in a supportive and purpose-drive environment
• Thoroughly and accurately answer questions about customers’ healthcare accounts
• Thoughtfully listen to callers’ needs and provide appropriate solutions
• Demonstrate a culture of ethical conduct, safety, and compliance
• Handle 35-50+ inbound and outbound phone calls per day
• Work closely with claim staff to make warranted adjustments to claims
• Other duties are based on business needs

Requirements:

• 2+ years of customer service experience; 1+ years in a TPA or payer setting
• Bachelor's degree or medical billing/coding certification
• Additional TPA or payer experience
• Strong communication, multitasking, and computer skills (Microsoft Office)
• Ability to work remotely and handle prolonged computer-based tasks
• Experience with self-funded plans preferred