Customer Service Representative PRN

Corewell Health • Saint Joseph, MI

1d • Onsite

About The Position

The Customer Service Representative works in an inbound call center assisting and educating members, employer groups, providers, colleagues, and agents about health plan benefits and access to services. The role helps resolve questions involving claims, billing, coding, and other service needs, and aims to provide an exceptional experience through inbound and outbound calls, face-to-face interactions, online chat, and email.

The representative responds to inquiries within departmental guidelines, coordinates with internal and external resources, and provides information about benefits, eligibility, authorization, billing, and claim status. The role also supports administrative member requests, facilitates claim resolution, documents interactions, identifies concerns or trends, and follows established procedures and work-schedule expectations.

Requirements

• High school diploma or equivalent.
• One year of relevant experience in a related field.

Nice To Haves

• Associate's degree.

Responsibilities

• Analyze, evaluate, resolve, and respond to service inquiries from members, providers, employer groups, colleagues, agents, Elite agents, and others within departmental guidelines.
• Provide professional and pleasant interactions with customers.
• Partner with internal and external resources to provide information and education about benefit clarification, eligibility requirements, verification, authorization, billing, and claim status.
• Identify and resolve or escalate customer concerns and complaints promptly.
• Place outbound welcome calls to members to educate them about their benefits as needed.
• Assist walk-in members and agents when assigned by leadership.
• Follow established procedures and quality guidelines supporting the service promise, performance indicators, corporate values, and codes of excellence.
• Identify potential trends or issues affecting members and suggest process improvements with coworkers and leadership.
• Assist members with administrative issues, including enrollment record changes, coverage or benefits letters, and providing member information to other departments as needed.
• Facilitate claims resolution by following up on member calls and correspondence with appropriate departments.
• Track and document customer service interactions in appropriate systems according to guidelines.
• Maintain productivity, availability to customers, and adherence to the work schedule.

Benefits

• Comprehensive benefits package addressing financial, health, and work/life balance goals.
• On-demand pay program powered by Payactiv.
• Discounts directory with deals on restaurants, phone plans, spas, and other offerings.
• Optional identity theft protection, home insurance, and auto insurance.
• Traditional and Roth retirement options with service contribution and matching savings.

What This Job Offers

• Job Type: Part-time
• Career Level: Entry Level
• Education Level: High school or GED