Commercial Health Customer Service Representative

To provide empathetic health insurance support, the full-time Commercial Health Customer Service Representative will manage inbound and outbound calls and email inquiries remotely, delivering accurate information on health plan benefits, eligibility, claims, and billing while ensuring a positive experience for members and providers. Key responsibilities Researches and resolves member and provider inquiries, meeting department metrics and turnaround times Explains plan benefits, eligibility, and claims processes while providing support for providers on claim status and prior authorization Collaborates with internal teams to document interactions and address complex issues effectively Required qualifications High school diploma or equivalent required 2+ years of customer service experience supporting commercial fully insured health plan business Working knowledge of commercial health plan benefits, eligibility, and claims processes Demonstrated knowledge of CPT, ICD-10, HCPCS, and Revenue Codes; Microsoft 365 proficiency required