Your next great career move starts here. We're looking for an Experienced Customer Service Representative - Work From Home to join our vibrant community at careerzynith. This role offers a great job, a competitive salary, and the flexibility to work from the comfort of your own home. As a Customer Service Representative, you will be the face of careerzynith, providing exceptional customer service to our members, providers, and plan sponsors. If you're passionate about delivering outstanding customer experiences, have a strong work ethic, and are looking for a new challenge, we want to hear from you.
**About careerzynith**
careerzynith is a leading organization in the industry, dedicated to providing innovative solutions and exceptional customer service. Our mission is to empower our customers to achieve their goals, and we're committed to building a community that values diversity, inclusion, and collaboration. As a Customer Service Representative at careerzynith, you'll be part of a dynamic team that's passionate about making a difference.
**Key Responsibilities**
As a Customer Service Representative, you will be responsible for:
* Answering questions and resolving issues based on phone calls, letters, and emails from members, providers, and plan sponsors
* Triaging resulting rework to appropriate staff
* Providing excellent customer service for high-volume inbound provider calls for the Claims Inquiry/Claims Research team
* Conducting extensive claims research on multiple platforms to assist providers with payment questions
* Providing related information to answer unasked questions, such as additional plan details, benefit plan details, and member self-service tools
* Using the customer service threshold framework to make financial decisions to resolve member issues
* Explaining member benefits and coverage provisions to resolve member issues
* Processing claim referrals, new claim handoffs, nurse reviews, complaints, and appeals via the target system
* Educating members on their benefits and coverage provisions
* Assisting in compiling claim data for customer audits
* Determining medical necessity, applicable coverage provisions, and verifying member plan eligibility relating to incoming correspondence and internal referrals
**Required Qualifications**
To be successful in this role, you must:
* Live in the state of Florida full-time
* Have familiarity with Microsoft Office products
* Have experience in a highly transactional call center environment
* Possess excellent customer service and critical thinking skills
* Have high-speed internet access (25 mbps or higher) and a consistent connection
* Set up your work location with a direct connection to the router (not Wi-Fi)
* Be able to work independently with minimal supervision
**Education**
A High School diploma or GED equivalent is required.
**Pay Range**
The typical pay range for this role is $25.00 - $38.00 per hour. The actual base salary offer will depend on a variety of factors, including experience, education, geography, and other relevant factors.
**Benefits**
As an careerzynith colleague, you'll enjoy a range of benefits, including:
* A competitive salary
* A comprehensive benefits package, including medical, dental, and vision benefits
* Eligibility for the careerzynith 401(k) retirement savings plan and Employee Stock Purchase Plan
* A fully-paid term life insurance plan
* Short-term and long-term disability benefits
* Numerous well-being programs, education assistance, and free development courses
* A CVS store discount and discount programs with participating partners
* Paid Time Off (PTO) or vacation pay, as well as paid holidays throughout the calendar year
**Work Environment and Company Culture**
As a Customer Service Representative at careerzynith, you'll work in a dynamic and supportive environment that values diversity, inclusion, and collaboration. Our team is passionate about delivering exceptional customer experiences, and we're committed to building a community that's inclusive and respectful. You'll have the opportunity to work with a talented team of professionals who share your passion for customer service and are dedicated to making a difference.
**Career Growth Opportunities and Learning Benefits**
careerzynith is committed to helping our colleagues grow and develop their careers. As a Customer Service Representative, you'll have access to a range of learning benefits, including:
* Free development courses and training programs
* Education assistance and tuition reimbursement
* Mentorship and coaching from experienced colleagues
* Opportunities for career advancement and professional growth
**How to Apply**
If you're passionate about delivering exceptional customer experiences and are looking for a new challenge, we want to hear from you. Apply now and take the first step towards a rewarding new role at careerzynith.
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**Equal Employment Opportunity**
careerzynith is an equal employment opportunity employer and welcomes applications from diverse candidates. We're committed to building a community that values diversity, inclusion, and collaboration. If you have a disability and require reasonable accommodation to apply or perform the essential functions of this role, please contact our HR department at 1-888-694-7287 or through our Leave at my HR.