Call Center Agent II

Job not on LinkedIn

🔥 5 minutes ago

🇲🇽 Mexico – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

📞 Call Center Representative

🚫👨‍🎓 No degree required

👻 Ghost score 10%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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HealthEdge

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 2005

🏥 Healthcare

💼 Consulting

⚕️ Healthcare Insurance

Healthcare • Consulting • Healthcare Insurance

HealthEdge is a company that specializes in providing advanced solutions for healthcare payers through its HealthRules Solutions Suite. This suite includes a comprehensive digital claims administration processing system, care management workflow solutions, and payment integrity solutions, which aim to enhance operational efficiency and improve quality of care for health plans. By leveraging integrated technology and automation, HealthEdge helps health plans eliminate data silos, increase payment accuracy, and elevate member experience, thereby transforming the healthcare landscape for better collaboration and accessibility.

📋 Description

• Receive and respond to inbound phone calls for customer assistance • Respond to outbound phone call requests • Document all calls in ticketing and tracking systems • Respond to customer inquiries and provide data within required time frames • Act as liaison between the claims department and providers • Research customer claims in primary payor systems • Ensure the highest level of customer service on every call • Perform other duties as assigned or necessary • Report to the Customer Service Manager • Work schedules related to the service center's 8am-6pm CST USA operating hours

🎯 Requirements

• High school degree required; Bachelor’s degree preferred • 2-3+ years of relevant professional experience in healthcare claims operations or a call center environment • Previous healthcare call center/customer service experience • Ability to work with minimal supervision • Comprehensive understanding of covered benefits, coding, reimbursement policies, and contracts • Excellent verbal and written communication skills • Attention to detail and problem-solving skills • Proficiency with MS Office applications, especially Word and Excel • Spanish speaking and written language proficiency preferred • Ability to work across multiple time zones in a hybrid or remote work environment • Long periods of sitting and/or standing in front of a computer using video technology • Candidates may be required to undergo a pre-employment criminal background check

🏖️ Benefits

• Full-time, permanent employment • May require travel dependent on company needs • Reasonable accommodations for individuals with disabilities • Equal opportunity and workforce diversity commitment