Contact Center Representative

Job title: Contact Center Representative

About the Role This role provides customer service in a call center setting, focusing on responding to and resolving employee benefit, coverage, eligibility and claims inquiries for medical, prescription, dental, life, disability, HRA and FSA coverages. Work is primarily telephonic, with email and secure portal messages also used, and confidentiality and HIPAA compliance are required.

What You'll Do

• Provide exceptional customer service by responding to inquiries from Covered Individuals, Retirees, Member Groups, vendors, and others about enrollment, benefits, services, claims, billing, and procedures; manage secure message center and email boxes; document inquiries accurately.
• Explain HealthTrust benefit programs and options (medical, dental, prescription drug, life, LTD, STD, FSA, HRA, wellness programs) and use internal resources to provide up-to-date information.
• Resolve calls and messages with high customer satisfaction; escalate to subject matter experts as needed; investigate, analyze, and correct problems; identify patterns and alert management.
• Maintain up-to-date knowledge of benefit programs and admin practices; create and update procedure manuals; communicate changes to the team; ensure compliance with policies, underwriting rules and applicable laws.
• Assist with claim issues; coordinate with providers, billing offices, and carriers to resolve problems; exercise ownership to ensure resolution.
• Support other staff with questions; participate in User Acceptance Testing of system updates.
• Provide regular administrative support to maintain a fully cross-trained team; handle cross-training and coverage.
• Coordinate with vendors to ensure enrollment data is up-to-date; view enrollment and claims information for Anthem, Delta and CVS Caremark.
• Facilitate credit card transactions for COBRA, Retiree, and Benefit Advantage payments.
• Contribute to HealthTrust educational efforts; assist with training sessions and related newsletters.

What We're Looking For

• Associate’s degree preferred (information processing, insurance or related field); two years of responsible customer service experience, preferably in health insurance or claims processing; proficiency in computerized data entry and word processing.
• Strong customer service, communication, and problem-solving skills; ability to explain complex benefits and procedures; familiarity with HIPAA and confidentiality requirements.
• Ability to work with internal staff and external vendors; ownership and initiative; cross-training mindset; ability to work with limited daily guidance.
• Knowledge of enrollment procedures, billing processes, and government regulations as applicable.

Nice to Have

• Additional education or specialized training in insurance, underwriting, or information processing.
• Experience with UAT testing and vendor systems; knowledge of Anthem, Delta, CVS Caremark enrollment data.

Compensation & Benefits

• Salary: $43,000-$47,000 per year (USD).