Serving as the first point of contact for members and providers, handling 30–40 calls per day while also managing chats, texts, emails, video, and co-browsing, with an expected call resolution time of 6 to 8 minutes.
Navigating multiple systems and balancing several interactions at once, staying accountable for accurate, timely, and empathetic resolutions.
Assuring the accurate and timely handling of client and member calls with total follow through.
Answering client and provider questions including, but not limited to claims payment, status and coverage information.
Educating customers on their plan and encouraging use of our digital tools—helping them learn how to navigate healthcare more confidently.
Interpreting client health plan protocol.
Reviewing claims status and providing status to member. Check tracer documentation.
Maintaining accurate and complete call documentation.
Maintaining high level of professionalism.
Returning incoming calls.
Solving questions about benefits, claims, eligibility, and providers, collaborating across teams when needed.
Safeguarding privacy at all times—strictly following HIPAA and confidentiality standards.
Documenting thoroughly, taking ownership of issues, and following through until every customer feels heard and supported.
Requirements
At least 2 years of experience in a healthcare contact center.
3+ years of customer service experience overall.
Associate or Bachelor's degree or recent work toward a degree is preferred.
Prior experience working across multiple customer service channels such as calls, chat, text, and email.
Tech-savvy with the ability to learn and pivot quickly across multiple systems.
Strong communication, listening, and problem-solving skills.
A calm, professional presence in high-volume situations, with empathy as a core strength.
Benefits
Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
call handlingclaims paymentclaims status reviewcall documentationcustomer servicehealth plan protocolproblem-solving