Back to jobs
New

Customer Service Representative

United States - Remote

Point C is a National third-party administrator (TPA) with local market presence that delivers customized self-funded benefit programs. Our commitment and partnership means thinking beyond the typical solutions in the market – to do more for clients – and take them beyond the standard “Point A to Point B.” We have researched the most effective cost containment strategies and are driving down the cost of plans with innovative solutions such as, network and payment integrity, pharmacy benefits and care management. There are many companies with a mission. We are a mission with a company.

The Customer Service Agent corresponds with callers providing benefit information, claim status, or general health plan information based on the schedule of benefits stated in the plan documents by performing the following duties. Training is conducted remotely and upon successful completion will work remotely. The schedule varies based on business needs but can be performed between the hours of 8:00 am to 8 pm Monday – Friday, Eastern Time zone.

Primary Responsibilities:

  • Create a welcoming experience by authentically engaging every caller, every time.
  • Make a connection with customers by engaging in friendly and genuine conversation throughout each call to provide a world-class experience.
  • Interacting with team and co-workers in a supportive and purpose-drive environment.
  • Thoroughly and accurately answer questions about customers’ healthcare accounts.
  • Thoughtfully listen to callers’ needs and provide appropriate solutions.
  • Demonstrate a culture of ethical conduct, safety, and compliance.
  • Handle 35-50+ inbound and outbound phone calls per day.
  • Work closely with claim staff to make warranted adjustments to claims.
  • Other duties are based on business needs.

Qualifications:

  • 2+ years of customer service experience; 1+ years in a TPA or payer setting.
  • Experience with self-funded plans preferred.
  • Bachelor’s degree or medical billing/coding certification.
  • Additional TPA or payer experience.
  • Strong communication, multitasking, and computer skills (Microsoft Office).
  • Ability to work remotely and handle prolonged computer-based tasks.
Benefits:
  • Comprehensive medical, dental, vision, and life insurance coverage
  • 401(k) retirement plan with employer match
  • Health Savings Account (HSA) & Flexible Spending Accounts (FSAs)
  • Paid time off (PTO) and disability leave
  • Employee Assistance Program (EAP)

 

Equal Employment Opportunity: At Point C Health, we know we are better together. We value, respect, and protect the uniqueness each of us brings. Innovation flourishes by including all voices and makes our business—and our society—stronger. Point C Health is an equal opportunity employer and we are committed to providing equal opportunity in all of our employment practices, including selection, hiring, performance management, promotion, transfer, compensation, benefits, education, training, social, and recreational activities to all persons regardless of race, religious creed, color, national origin, ancestry, physical disability, mental disability, genetic information, pregnancy, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, and military and veteran status, or any other protected status protected by local, state or federal law.

 

Create a Job Alert

Interested in building your career at Point C? Get future opportunities sent straight to your email.

Apply for this job

*

indicates a required field

Resume/CV*

Accepted file types: pdf, doc, docx, txt, rtf

Cover Letter

Accepted file types: pdf, doc, docx, txt, rtf

Education

Select...
Select...
Select...
Select...
Select...
Select...

Please provide the date you would be available to begin employment if selected.

Select...
Select...

This includes any future need for visa sponsorship (e.g., H-1B, O-1, etc.)

Please include your full earnings expectations, including base salary, bonus, and/or commission.

Please enter your primary work location city.

Select...

If different from your current location, please enter the state you plan to work from upon starting.

Select...
A member calls in, highly upset and angry because their recent claim for a surgery was denied. What is the first thing you should do? *
A doctor's office calls stating they cannot verify a patient's eligibility and are threatening to cancel the patient's upcoming procedure. How do you respond? *
An adult member's spouse calls in and asks to check status of a recent claim. Can you give them this information? *
A member calls because their Explanation of Benefits (EOB) shows they owe $100, but they believe they only have a $20 copay for this specific visit. Where do you look to resolve this? *

Voluntary Self-Identification

For government reporting purposes, we ask candidates to respond to the below self-identification survey. Completion of the form is entirely voluntary. Whatever your decision, it will not be considered in the hiring process or thereafter. Any information that you do provide will be recorded and maintained in a confidential file.

As set forth in Point C’s Equal Employment Opportunity policy, we do not discriminate on the basis of any protected group status under any applicable law.

Select...
Select...
Race & Ethnicity Definitions

If you believe you belong to any of the categories of protected veterans listed below, please indicate by making the appropriate selection. As a government contractor subject to the Vietnam Era Veterans Readjustment Assistance Act (VEVRAA), we request this information in order to measure the effectiveness of the outreach and positive recruitment efforts we undertake pursuant to VEVRAA. Classification of protected categories is as follows:

A "disabled veteran" is one of the following: a veteran of the U.S. military, ground, naval or air service who is entitled to compensation (or who but for the receipt of military retired pay would be entitled to compensation) under laws administered by the Secretary of Veterans Affairs; or a person who was discharged or released from active duty because of a service-connected disability.

A "recently separated veteran" means any veteran during the three-year period beginning on the date of such veteran's discharge or release from active duty in the U.S. military, ground, naval, or air service.

An "active duty wartime or campaign badge veteran" means a veteran who served on active duty in the U.S. military, ground, naval or air service during a war, or in a campaign or expedition for which a campaign badge has been authorized under the laws administered by the Department of Defense.

An "Armed forces service medal veteran" means a veteran who, while serving on active duty in the U.S. military, ground, naval or air service, participated in a United States military operation for which an Armed Forces service medal was awarded pursuant to Executive Order 12985.

Select...