Customer Care Rep II - Fully Remote!

About Our Client:
SKYGEN partners with specialty benefits payers and government agencies to manage dental and vision benefits delivery and administration. The organization addresses challenges in healthcare benefits administration by providing technology and service solutions aimed at improving efficiency and effectiveness in healthcare organizations.
About the Opportunity:
The CUSTOMER CARE REP II role involves directly supporting customers by addressing inquiries related to dental and vision benefits. This position is responsible for delivering accurate information, resolving issues, and facilitating communication between providers and member services. The role contributes to a smooth customer experience and supports the organization's operational success.
Responsibilities:
Handle inbound calls regarding eligibility, benefit coverage, authorizations, claims, and provider location assistance
Resolve provider requests using knowledge of claim adjustments and resubmission processes
Provide feedback to Provider Relations on claim issues affecting reimbursement and information accuracy
Support enrollment activities including assigning primary care providers and updating insurance information
Liaise with client Member Services to resolve eligibility issues and manage appeals and grievances
Update providers on credentialing application status
Educate providers on using the provider web portal for common inquiries
Ensure call handling meets company and client standards
Document call details and resolutions accurately in internal systems
Apply de-escalation techniques to maintain positive customer interactions
Identify and escalate issues requiring leadership attention
Recommend system and process improvements to management
Communicate provider-related updates to Provider Relations
Participate in departmental projects as needed
Requirements:
High school diploma or equivalent
Minimum 1 year customer service experience in healthcare, call center, banking, or retail
Basic proficiency with Microsoft Word, Excel, and Outlook
Ability to work occasional overtime
Strong listening, communication, and customer service skills with empathy
Accurate data entry and typing skills
Proficient in multitasking and navigating computer systems
Detail-oriented with critical thinking to assess and address customer needs
Preferred:
Customer service experience in dental, vision, or medical insurance
Experience in a virtual work environment
Familiarity with dental, vision, or medical insurance terminology
Pay Range and Compensation Package:
The pay range and compensation package for this role will be determined based on the candidate's experience, skills, and other relevant factors.
Benefits & Perks:
$2.00/hour differential on Mondays and Tuesdays
Fully remote work opportunity
Training schedule Monday to Friday, 8:00 am to 4:30 pm CST for first 12 weeks
Flexible work schedule options after training with start times between 6:00 am and 10:30 am CST
Potential for occasional evening, weekend, and holiday work during Medicare Annual Open Enrollment (October 1 to March 31)
Opportunities for professional growth
Equal Opportunity Statement: Our client is an equal opportunity employer. They celebrate diversity and are committed to creating an inclusive environment for all employees. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, or national origin.
Note:
RemoteHunter is a recruitment partner of this role. Please note that all employment decisions, including candidate assessment, interviews, hiring, compensation, and employment terms, are made exclusively by the hiring employer.

Work arrangement
Yes