Remote Healthcare Customer Service Representative

Conduent Commercial Solutions, LLC•, Remote US

9d•Remote

About The Position

Conduent is hiring a remote call center representative to support members, providers, and employer groups with healthcare-related calls about dental benefits. The role handles inquiries for Commercial and Medicare plans, including eligibility, claims, appeals, grievances, and provider searches. Representatives investigate concerns, explain benefits and policies, document interactions, and work toward resolving issues. The position requires navigating six systems and averaging 32 calls per day, while meeting assigned monthly performance and quality goals. Training consists of five weeks of classroom instruction and two weeks of nesting. Employees must complete the mandatory paid training program with 100% attendance. Hours of operation are Monday through Sunday, 7:30 a.m. to 11:00 p.m. EST; a specific individual schedule is not stated. Conduent provides the computer, monitor, mouse, keyboard, headset, ethernet cord, and power cables. Employees must provide qualifying home internet service, connect the work computer directly to the modem by ethernet, and maintain a distraction-free, secure workspace. The listed pay rate is $16 per hour. Medical, dental, and vision benefits are available on the first day of employment. Paid time off begins accruing after 180 days. Hiring is limited to locations where the compensation complies with applicable wage requirements, and the posting lists states and metro areas where applicants are not currently being hired.

Requirements

Successfully complete the customer service assessment and typing test.
High school diploma, GED, or college degree.
One year of face-to-face customer service experience.
Self-motivation, resourcefulness, attention to detail, accountability, and ability to work as part of a team.
Strong organizational, time-management, written and verbal communication, analytical, and problem-solving skills.
Proficiency in Microsoft Word, Microsoft Outlook, and Internet Explorer.
Effective communication skills over the phone.
Ability to deal with problems involving several concrete variables in standardized situations.
Successful completion of a background check.
Complete mandatory paid training with 100% attendance.
Have a home internet connection with at least 10 Mbps download and 3 Mbps upload speeds; satellite and wireless internet are not acceptable.
Be able to connect the work computer directly to the home modem via ethernet and maintain a distraction-free, secure workspace.

Nice To Haves

At least one year of call center experience is preferred.
Knowledge of and prior experience in the dental, medical, or managed care industry is preferred.

Responsibilities

Respond to inbound inquiries about dental benefits, eligibility, claims, appeals, grievances, and provider searches for Commercial and Medicare plans.
Explain and clarify dental benefits, policies, and procedures for members, providers, and employer groups.
Investigate member or provider concerns, contact appropriate parties, and accurately document interactions in the billing system.
Investigate verbal complaints about billing, claims, or services, and escalate service failures to appropriate internal departments for follow-up and resolution.
Retrieve and send written correspondence, including plan brochures, provider directories, and other printed materials.
Meet or exceed established call-volume and quality performance goals in the ACD system.
Achieve assigned individual monthly performance metrics.
Maintain current knowledge of Member Services policies, procedures, and dental plan updates.
Perform additional duties and responsibilities as assigned by management.