Onsite Customer Service Representative (Healthcare)

Qualfon • Casselberry, FL

39d • Onsite

About The Position

Join Our Team - Assisting customers with their Health Benefits! We are seeking a compassionate, service-oriented Member Advocate to join our team and support members in navigating the healthcare system. As the first point of contact, the Member Advocate provides personalized, high-quality support to help members understand their health benefits, access essential services, and coordinate care. The ideal candidate thrives in a fast-paced, multi-channel environment and is passionate about making a meaningful difference in the lives of others. Must be able to work onsite: 105 Live Oaks Gardens, Casselberry, FL 32707 Why You Will Love Working Here: Meaningful work that genuinely helps people. Consistent weekday schedule - no weekends required! A supportive team that prioritizes empathy and excellence. Opportunities for growth within a stable, respected organization. Ready to Make a Difference? If you're passionate about helping others, apply today and join a team where your voice matters!

Requirements

• High school diploma or GED required, college coursework a plus.
• Must be at least 18 years of age.
• 1+ year of customer service experience (call center and/or healthcare preferred).
• Typing speed of 25 WPM with 90% accuracy required.
• Strong communication skills-clear, caring, and professional.
• Solid computer skills, including MS Office and navigating the web.
• Reliability, flexibility, and a commitment to getting the job done right.

Responsibilities

• Serve as a single point of contact for members, building trusted relationships and assisting with provider access, appeals, claims, and services.
• Explain plan benefits and resolve claims and benefit issues via phone or digital communication.
• Ask questions to identify member needs, including those outside their current benefits.
• Handle inbound and outbound inquiries through phone, email, mail, and chat.
• Help schedule appointments, arrange transportation, find providers, issue ID cards, and guide members in using online tools.
• Proactively reach out to members for health campaigns and wellness follow-ups.
• Coordinate with providers, Care Managers, and vendors; warm transfer members and remain on the line if needed to ensure resolution.
• Work closely with internal teams and healthcare providers to resolve issues and ensure a smooth member experience.
• Document actions taken and communicate follow-up timelines to members.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Administrative and Support Services
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees