Remote Customer Service Representative

Pride Health is hiring a Remote Customer Service Representative to support their client's managed care organization. The role involves handling inbound provider calls, documenting details, and meeting performance metrics while providing professional service.

Responsibilities:

• Handle inbound provider calls related to claims, benefits, eligibility, and general inquiries
• Document call details accurately in the system for tracking and follow-up
• Meet daily performance metrics, including Average Handle Time (AHT), quality, and adherence
• Monitor call queues and adjust status usage to support service level goals
• Escalate complex issues to appropriate departments or team leads
• Provide empathetic and professional service to all callers
• Participate in team meetings and training sessions to stay updated on policies and procedures

Requirements:

• High School Diploma or equivalent
• Experience in healthcare customer service, preferably in a provider-facing role
• Familiarity with claims processing, benefits, and eligibility
• Prior experience in a high-volume call center environment
• Understanding of HIPAA regulations and confidentiality standards