Provider Customer Service Representative (Health Insurance)

• Claims: Status, denial rationales, appeals, medical records, research/routing, EOB/EOP requests.

• Authorizations & UM: Status, denial rationales, utilization management appeals, prior auth verification.

• Eligibility & Benefits: Status, benefit grid interpretation, provider participation, credentialing.

• Call Handling & Admin: Thorough call documentation, resolving next steps, educating providers on self-service tools (Availity), and back-to-back call management.

• Pay & Schedule: $16/hour, paid training, Mon–Fri (8 AM–5 PM EST).

• Perks: Medical/dental/vision, flexible vacation (post-training), company equipment, EAP/wellness with a dedicated trainer, employee discounts, and 80% internal promotion rate.

Requirements

• Education & Experience: High School Diploma (or equivalent); 1–2 years high-volume call center experience.

• Skills: 35–40 WPM typing, strong written/verbal communication, active listening, problem-solving, and multitasking.

• Workplace & Tech: Dedicated quiet workspace, strict schedule adherence, and internet speeds of at least 10 Mbps download / 2 Mbps upload.

• Eligibility: Must be a US resident authorized to work in the US.

Preferred Qualifications

• 1–2 years in a medical office, healthcare insurance, billing/coding, or back-end processing.

This role is open to those eligible to work in the USA.

EEOC and Veteran Documentation
During employment, employees are treated without regard to race, color, religion, sex, national origin, age, marital or veteran status, medical condition or handicap, or any other legally protected status.
At times, government agencies require periodic reports from employers on the sex, ethnicity, handicap, veteran and other protected status of employees. The purpose of this Administrative EEO Record is for statistical analysis only and is used to comply with government record keeping, reporting, and other legal requirements. Periodic reports are made to the government on the following information. The completion of the Administrative EEO record is optional. If you choose to volunteer the requested information, please note that all
Administrative EEO Records are kept in a Confidential File and are not part of your Application for Employment or Personnel file.
Please note: YOUR COOPERATION IS VOLUNTARY. INCLUSION OR EXCLUSION OF ANY DATA WILL NOT AFFECT ANY EMPLOYMENT DECISION.