Client Services Representative - Remote

Remote US

Our mission is to enhance well‑being by connecting individuals with vital health resources through a compassionate workforce that embodies the spirit of neighbors helping neighbors.

Health One is guided by a cultural framework that embodies our values and drives our decisions.

Our PURPOSE is to care for people by connecting them to resources that help protect them in health related situations. To fulfill our purpose, we align our PRIORITIES to ensure each decision we make is ethical, empathetic, economical, and efficient. We care for PEOPLE by being welcoming, authentic, truthful, consistent and humble. We are continuously looking for ways to improve our PROCESS and how we get things done.

The Client Services Representative addresses inquiries, questions and concerns in all areas including enrollment, eligibility, claims, benefit interpretation, and referrals/authorizations for medical care. The position is responsible for receiving, responding to, and directing member, broker and provider phone calls and other communications and provides available information upon request and escalates issues as appropriate.

• Receives client calls or inquiries, which include potential/current/previous members, brokers and providers, and routes appropriately
• Provides timely and accurate information to clients
• Processes client requests according to established department policies and procedures
• Completes research and investigative activities to address client inquiries
• Works closely with other departments to gather information
• Provides timely feedback to clients through outbound calling, email, mail or fax
• Provides timely feedback to the company regarding service failures, systemic issues or client concerns
• Assists in the completion of special projects
• Assists in the documentation, evaluation and revision of department policies and procedures
• Meets or exceeds service level agreements in call center metrics
• Attends and participates in meetings and trainings as required
• Regular and predictable attendance
• Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
• Maintains regular and predictable attendance
• Consistently demonstrates compliance with HIPAA regulations, professional conduct, and ethical practice
• Works to encourage and promote Company culture throughout the organization
• Other duties as may be assigned

• Requires a high school diploma or its equivalent
• Ability to learn quickly and be self‑motivated
• Customer service experience preferred
• Confidentiality and time management skills
• Bilingual preferred
• Knowledge of healthcare billing, claims and insurance a bonus

Prolonged periods of sitting at a desk and working on a computer. Moderate to significant amount of stress in meeting deadlines and dealing with day‑to‑day responsibilities. Must be able to drive a vehicle and daytime/overnight travel as required.

• 401K (4% Match, Immediate Vesting)
• Accident insurance
• Competitive salary
• Critical Illness Insurance
• Dental Insurance
• Employee Assistance Program
• Flexible Spending Account
• Health & Wellness Program
• Health Savings Account
• Life & AD&D Insurance
• Long Term Disability Medical Insurance
• Medical Insurance
• Paid Time Off
• Pet Insurance
• Short Term Disability
• Vision Insurance