Customer Care Rep II - Part Time - Fully Remote!

SKYGEN•United States,

2d•$16 - $25•Remote

About The Position

The Customer Care Representative II provides empathetic customer service to callers, patiently listening to understand questions and finding viable solutions while delivering a positive customer experience. This is a fully remote, part-time role supporting Dental and Vision services. Training is scheduled from 8:00 a.m. to 4:30 p.m. CST, Monday through Friday, for the first three weeks. After training, available schedules have start times ranging from 9:00 a.m. to 11:00 a.m. CST, Monday through Friday. Hours of operation are 6:00 a.m. to 10:00 p.m. CST, Monday through Friday, and shifts may vary based on business needs. Occasional evening, weekend, and holiday work may be required during Annual Medicare Open Enrollment, October 1 through March 31. A $2.00-per-hour differential applies on Monday and Tuesday. SKYGEN partners with specialty benefits payers and government agencies to administer dental and vision benefits through technology and service solutions. The role also contributes to process improvements and departmental projects, with opportunities for professional growth.

Requirements

High school diploma or equivalent.
At least 1 year of job-related customer service experience in an industry such as healthcare, call center, banking, or retail.
Basic knowledge of Microsoft Office products, including Word, Excel, and Outlook.
Ability to work occasional overtime as needed.
Excellent listening and communication skills.
Strong customer service skills and the ability to provide empathy.
Strong data entry and typing skills.
Strong navigation skills and ability to multitask.
Excellent attention to detail.
Critical-thinking skills to understand customer needs and use available knowledge and resources to provide appropriate solutions.

Nice To Haves

At least 1 year of job-related customer service experience in the dental, vision, or medical industry.
Previous experience working in a virtual environment.
Understanding of dental, vision, and/or medical insurance terminology.

Responsibilities

Assist Dental and Vision inbound callers with eligibility, benefit coverage, authorizations, claims, and provider location questions.
Use knowledge of claim adjustments and resubmission processes to resolve provider requests.
Provide Provider Relations staff with feedback on high-level claim issues, including reimbursement schedule concerns and conflicting information.
Support enrollment activities, including assigning primary care providers and updating third-party insurance information.
Act as a liaison between the organization and client Member Services staff to resolve issues such as eligibility questions and appeals or grievances.
Update providers on the status of credentialing applications.
Educate providers about the provider web portal and identify questions that could be handled through it.
Answer calls according to company and client guidelines.
Document call information and resolutions accurately in internal systems.
Use effective de-escalation techniques so customers feel heard, valued, and supported.
Identify issues that require escalation to the leadership team.
Recommend system enhancements and process improvements to management.
Keep Provider Relations informed about provider manual discrepancies, location changes, and other provider-related issues.
Participate in departmental projects when applicable.