Make a real difference in people’s lives by connecting with them on a personal level. As a Customer Service Representative with a Fortune 100 healthcare company, through Aquent, you’ll be the voice of support, guiding members through their healthcare journeys and ensuring they receive the best possible care. This is an opportunity to build meaningful connections, provide empathetic support, and champion for members’ well-being.
Aquent has an exciting opportunity for a Customer Service Representative in Oklahoma!
While this position is 100% remote, candidated must currently live in Oklahoma and work 8:00 AM – 5:00 PM CDT Monday-Friday.
In additiion to be considered for this role, you must:
- Be authorized to work in the United States
- Not require sponsorship of any kind for the duration of the assignment
This role goes beyond traditional customer service. You will be a trusted advisor, empowering members to understand their benefits, navigate complex healthcare processes, and access the resources they need. You will be a key player in ensuring member satisfaction and retention, directly impacting the company’s success.
What You’ll Do:
- Answer member, provider, and plan sponsor inquiries via phone and written correspondence, resolving issues and escalating complex cases as needed.
- Document and track all interactions, ensuring accurate record-keeping and follow-up.
- Guide members through their benefit plans, policies, and procedures, providing clear and concise explanations.
- Connect with members on an emotional level, building trust and rapport to understand their unique needs.
- Proactively anticipate member needs, offering additional information and resources to enhance their experience.
- Make informed financial decisions within established guidelines to resolve member issues effectively.
- Explain member rights and responsibilities in accordance with contractual agreements.
- Process claim referrals, new claim handoffs, nurse reviews, complaints, grievances, and appeals.
- Educate providers on self-service options and assist with credentialing and re-credentialing processes.
- Respond to legal document requests and assist in preparing complaint trend reports and claim data for audits.
- Determine medical necessity, verify coverage provisions, and member eligibility.
- Handle appeals and pre-authorization requests.
- Review member claim history to ensure accurate tracking of benefits, maximums, and cost-sharing.
- Generate quality letters and spreadsheets in response to inquiries, utilizing available systems and resources.
Must-Have Qualifications
- High School Diploma or GED equivalent.
- Proven customer service experience, preferably in a fast-paced environment like a call center or retail setting, demonstrating empathy and compassion.
- Experience working in a production-oriented environment.
The target hiring compensation range for this role is $15.71 to $17.72 an hour. Compensation is based on several factors including, but not limited to education, relevant work experience, relevant certifications, and location.
About Aquent Talent:
Aquent Talent connects the best talent in marketing, creative, and design with the world’s biggest brands.
Our eligible talent get access to amazing benefits like subsidized health, vision, and dental plans, paid sick leave, and retirement plans with a match. We also offer free online training through Aquent Gymnasium. More information on our awesome benefits!
Aquent is an equal-opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics. We’re about creating an inclusive environment-one where different backgrounds, experiences, and perspectives are valued, and everyone can contribute, grow their careers, and thrive.
#LI-GS1
#app