90 Degree Benefits Medical Customer Service Representative
Location: Duluth, GA preferred; hybrid schedule
Remote: Remote candidates will be considered
Department: Customer Service
Reports To: Claims & Customer Service Manager
Non-Exempt/Hourly Monday through Friday 8:30 to 5 EST 37.5 workweek
90 Degree Benefits Customer Service Representative
Pay: $18.00 - $21.00 per hour
Position Summary
We are looking for a detail-oriented Medical Customer Service Representative (CSR) to join our Third-Party Administrator (TPA) team supporting health benefit programs. In this role, the CSR serves as a primary point of contact for members, providers, and employer groups. The CSR manages a high volume of inbound and outbound calls, researches and resolves issues accurately and efficiently, processes identification card requests, and provides support for member portal access.
The ideal candidate has 3–5 years of customer service experience, preferably within the medical insurance, health benefits, or TPA industry.
Essential Responsibilities
Respond to a high volume of inbound calls from members and healthcare providers regarding plan benefits, eligibility, claim status, coverage, and general account inquiries.
Place outbound calls to providers, members, and other stakeholders to obtain additional information, resolve claim discrepancies, and support timely issue resolution.
Assist members with access to the 90 Degree Benefits member portal.
Assist members with Identification (ID) card requests accurately and efficiently.
Maintain accurate documentation of customer interactions, inquiries, and resolutions in applicable systems.
Manage daily incoming claims received through the Claims Inbox.
Collaborate with Claims, Eligibility, Enrollment, and other internal departments to resolve member and provider concerns.
Protect confidential member information and maintain compliance with HIPAA and applicable privacy and security regulations.
Meet established quality, productivity, and service-level performance standards.
Perform additional duties and special projects assigned.
Desired Skills
· Strong analytical and critical thinking skills.
· Excellent attention to detail and accuracy.
· Ability to interpret benefit plans and claim documentation.
· Strong organizational and time management skills.
· Ability to work independently, prioritize workload, and learn new systems quickly.
· Excellent written and verbal communication skills.
· Proficiency with Microsoft Office, particularly Outlook and Excel.
· Positive attitude and willingness to learn.
Required Qualifications
High School Diploma or GED required.
Minimum of 2 years of customer service experience, preferably within healthcare, health insurance, benefits administration, or a related customer support environment.
Proficiency with Microsoft Office Suite, including Outlook, Word, Excel, and Microsoft Teams.
Preferred Qualifications
Experience in the healthcare, health insurance, TPA, or benefits administration industry.
Familiarity with medical terminology, deductibles, copays, coinsurance, out-of-pocket maximums, Explanation of Benefits (EOBs), and Coordination of Benefits (COB).
Experience with LuminX claims software preferred.
Bilingual communication skills are preferred.
What We’re Looking For
We are looking for someone who enjoys helping people, communicates professionally, takes ownership of problems, and thrives in a fast paced, collaborative environment. The ideal candidate is dependable, detail-oriented, eager to learn, and committed to delivering an outstanding customer experience.
The ideal candidate has 3–5 years of customer service experience, preferably within the medical insurance, health benefits, or TPA industry.
Why Join Our Team?
Competitive compensation based on experience.
Comprehensive benefits package, including medical, dental, vision, paid time off, retirement benefits, and other company-sponsored benefits.
Stable growing organization with an excellent reputation in the employee benefits industry.
Collaborative, team-oriented culture where employees support one another.
Opportunities for ongoing training, professional development, and career growth.
Meaningful work where you’ll build lasting relationships and make a direct impact on our clients’ experience.
Benefits:
- 401(k)
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Pay: $18.00 - $21.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Retirement plan
- Vision insurance
Work Location: Hybrid remote in Duluth, GA 30097
