Remote Healthcare Customer Service Representative
San Jose, Santa Clara County, California, 95199, USA
Listed on 2026-10-09
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Customer Service/HelpDesk
Customer Service Rep, Call Center / Support, Bilingual
Through our dedicated associates, Conduent delivers mission‑critical services and solutions on behalf of Fortune 100 companies and over 500 governments – creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.
Remote Call Center Representative
Would you enjoy being part of a team that makes a difference in people’s lives? Do you love helping people solve complex problems and deliver solutions? We are looking for people with a passion for helping others, naturally empathy, and are determined to deliver a comprehensive solution to healthcare‑related calls. To be successful customer service experience is a plus, but not a requirement.
Conduent has plenty of growth opportunities within the healthcare team.
- The pay rate is $16 per hour, which may be below your state’s minimum wage. Please take this into consideration when applying.
- Training is 5 weeks classroom and 2 weeks nesting.
- Successfully complete a mandatory paid training program with 100% attendance.
- Hours of operation:
Monday — Sunday 7:30am — 11:00pm EST - Medical, dental and vision benefits are available on the 1st day of employment.
- Paid time off is accrued after 180 days (about 6 months) of employment.
- Successfully navigate 6 systems and average 32 calls per day.
- Respond to inbound inquiries regarding dental benefits, eligibility, claims, appeals, grievances, and provider searches for both Commercial and Medicare plans.
- Provide uniform interpretation and clarification of dental benefits, policies, and procedures to members, providers, and employer groups.
- Actively attempt to resolve member or provider concerns by investigating issues, contacting appropriate parties, and documenting all interactions accurately within the billing system.
- Investigate verbal complaints regarding billing, claims, or services rendered; elevate service failures to appropriate internal departments for follow‑up and resolution.
- Retrieve and send written correspondence, including plan brochures, provider directories, and other printed materials as needed.
- Meet or exceed established ACD (Automated Call Distribution) system call volume and quality performance goals.
- Achieve all assigned individual monthly performance metrics.
- Maintain current and thorough knowledge of all Member Services policies, procedures, and dental plan updates.
- Perform additional duties and responsibilities as assigned by management.
- Successfully complete customer service assessment & typing test.
- High school diploma, GED, or college degree
- At least 1 year of Call Center experience preferred.
- 1 year of face‑to‑face customer service experience.
- Knowledge of and prior experience in the Dental, Medical or Managed Care industry is preferred.
- Must possess the following characteristics: self‑motivation, resourceful, detail‑oriented, sense of accountability and must be a team player.
- Must possess strong skills in the following areas: organizational, time management, written and verbal communication, analytical, and problem solving.
- Proficiency in Microsoft Word, Microsoft Outlook, and Internet Explorer.
- Effective communication skills over the phone.
- Ability to deal with problems involving several concrete variables in standardized situations.
- Successful completion of background check is required for this position.
- We provide all equipment. (Computer, Monitor, Mouse, Keyboard, Headset, Ethernet Cord, Power Cables)
- You must have a home internet connection of 10 Download and 3 Upload Speed (you may do a…
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