Experienced Health Insurance Customer Service Advocate – Remote Inbound Call Center Agent

Join careerzynith as a Health Insurance Customer Service Advocate, where you will play a vital role in delivering exceptional customer service to our members and healthcare providers. As a remote Inbound Call Center Agent, you will have the opportunity to work from the comfort of your own home, while making a meaningful impact in the lives of our members.

• *About careerzynith**

careerzynith is a leading company in the health insurance industry, dedicated to providing innovative solutions and exceptional customer service to our members. Our mission is to empower individuals and families to take control of their health and well-being, and we're looking for passionate and dedicated professionals like you to join our team.

• *Job Highlights:**

• Immediate start date with competitive salary and permanent hire opportunity

• Remote work arrangement with flexible scheduling (Monday - Friday, 7am-7pm CST)
• Opportunity to work with a leading company in the health insurance industry
• Professional growth and development opportunities
• *Job Description:**

In this role, you will work closely with members and healthcare providers to facilitate prior authorization creation, review pending statuses, and enroll members in our Chronic Medical Condition (CMC) programs. Your responsibilities will include:

• Reviewing member policies and qualifications to determine program eligibility
• Informing members about available programs and setting up appointments with providers
• Meeting production, quality, and regulatory expectations in a call center environment
• Ensuring accurate documentation and case setup
• Demonstrating proficiency in decision-making and problem-solving using available resources
• Making outbound calls to providers and members as needed
• *Key Responsibilities:**

• Provide exceptional customer service to members and healthcare providers via phone, email, and chat

• Facilitate prior authorization creation and review pending statuses
• Enroll members in our Chronic Medical Condition (CMC) programs
• Review member policies and qualifications to determine program eligibility
• Inform members about available programs and set up appointments with providers
• Meet production, quality, and regulatory expectations in a call center environment
• Ensure accurate documentation and case setup
• Demonstrate proficiency in decision-making and problem-solving using available resources
• Make outbound calls to providers and members as needed
• *Qualifications:**

• High School Diploma/GED required (verifying document will be required)

• 1+ years of professional experience in a medical or health insurance environment
• Prior customer service experience making outbound calls
• Proficiency in using a computer and Microsoft Office Products (Outlook, Word, Excel)
• Ability to work an 8-hour shift (Monday-Friday, 7am-7pm CST) and flexibility to work outside standard hours as needed
• Designated work area with secure and reliable high-speed internet connection (minimum 2mps upload/download speed)
• *Essential Skills:**

• Strong written and verbal communication skills

• Excellent critical thinking, problem-solving, and analytical skills
• Highly organized with ability to exercise good judgment
• Ability to work in a fast-paced environment and meet production expectations
• Strong attention to detail and accuracy
• Ability to work independently and as part of a team
• *Preferred Qualifications:**

• Experience working in a call center environment

• Knowledge of health insurance industry and regulations
• Experience with prior authorization creation and review
• Certification in customer service or a related field
• *Career Growth Opportunities and Learning Benefits:**

• careerzynith offers a comprehensive training program to ensure your success in this role

• Opportunities for professional growth and development in a dynamic and innovative company
• Access to ongoing training and education to enhance your skills and knowledge
• Collaborative and supportive work environment with a team of dedicated professionals
• *Work Environment and Company Culture:**

• careerzynith is committed to creating a positive and inclusive work environment that values diversity, equity, and inclusion

• Our company culture is built on a foundation of respect, empathy, and open communication
• We offer a flexible and remote work arrangement to support work-life balance and employee well-being
• careerzynith is an equal opportunity employer and welcomes applications from diverse candidates
• *Compensation, Perks, and Benefits:**

• Competitive salary and benefits package