Customer Service Representative Troy, MI

Customer Service Representative

We are looking for a dedicated and customer-focused Customer Service Representative to join our team in Troy, Michigan. This Contract position offers an opportunity to assist customers with their medical-related inquiries in a detail oriented and supportive environment. You will handle a variety of tasks, including answering questions about benefits, claims, and pre-authorizations, ensuring a high standard of customer satisfaction. This role is primarily remote, but occasional in-office attendance will be required.

Responsibilities:

• Respond to customer inquiries via phone and email, providing accurate and timely information.
• Resolve issues related to pre-authorizations, claim statuses, and benefit details with attention to detail.
• Maintain detailed and accurate records of all customer interactions using company systems.
• Stay informed about updates and changes to healthcare plans and policies.
• Guide customers through their medical benefits and network provider options.
• Provide pre-authorization for medical treatments when applicable.
• Address outstanding co-payments and explain financial responsibilities to members.
• Escalate unresolved issues to the appropriate manager when necessary.
• Ensure compliance with HIPAA policies and maintain confidentiality at all times.
• Work efficiently in a high-volume call environment while providing excellent service.