Job Opening: Medical Insurance Customer Service Representative

The Cow Creek Band of Umpqua Tribe of Indians is excited to announce an opportunity for a dedicated individual to join our organization as a Medical Insurance Customer Service Representative. This Full-Time position is located at our tribal offices and is not eligible for remote work. We are looking for a candidate who is committed to providing exceptional customer support and possesses a strong understanding of healthcare benefits and insurance protocols. The chosen candidate will play a vital role in interacting with our community members and healthcare providers, ensuring they receive the highest level of service and support.

Job Description

As a Medical Insurance Customer Service Representative, you will be at the forefront of customer interaction for our health benefits plans. The purpose of this position is to offer timely support for our members and providers through inquiries and claims, ensure understanding of plan benefits, and contribute to an overall positive experience by resolving concerns efficiently and professionally. The role requires an individual who is compassionate, dynamic, and capable of managing multiple tasks in a structured health service environment.

Duties and Responsibilities

• Work efficiently in a high-volume call center while maintaining a professional, team-oriented, positive, and caring demeanor.
• Assist callers with benefit-related questions/concerns and provide accurate interpretation of claims and Plan benefits.
• Maintain accounts and records of membership and interactions with details of inquiries, complaints, and comments.
• Work efficiently in multiple systems simultaneously while effectively utilizing critical thinking and problem-solving skills.
• Maintain confidentiality and project a professional business presence and appearance.
• Performs other related duties as assigned.

Requirements

• Service-oriented.
• Excellent verbal and written communication skills including active listening.
• Customer service experience preferred.
• Knowledge of Medical Terminology and health benefits preferred.
• Proficient computer skills with the ability to learn new software.
• Organized with attention to detail.
• Ability to multi-task and work independently with minimal supervision.
• High school diploma or equivalent.