Customer Service Representative

Sagility is hiring a Work from Home Customer Service Representative to support healthcare members and patients. In this fully remote role, you'll answer inbound calls, verify member information, explain benefits, resolve billing and claims issues, and document all interactions accurately in our systems. You'll follow HIPAA and quality guidelines while using scripts, knowledge bases, and digital tools to research and resolve concerns.

Collaborating with your team and leadership, you'll identify trends, escalate complex issues, and contribute to continuous improvement of the member experience in a fast-paced, mission-driven environment.

Responsibilities

• Answer inbound calls and respond to member and patient inquiries
• Verify member identity and accurately explain healthcare benefits and coverage
• Research and resolve basic billing, claims, and service issues
• Document call details and outcomes in CRM and related systems
• Follow HIPAA, compliance, and quality assurance guidelines
• Use scripts, knowledge bases, and digital tools to support resolutions
• Escalate complex issues to appropriate teams or supervisors
• Meet or exceed performance metrics for quality, accuracy, and productivity
• Collaborate with team members to share insights and best practices
• Contribute feedback to improve processes and member experience

Required Skills

• Customer service
• Call center operations
• Healthcare terminology
• Benefits and claims explanation
• CRM software usage
• Data entry and documentation
• HIPAA compliance awareness
• Problem solving
• Verbal and written communication
• Basic computer skills