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Healthcare Customer Service Representative - Remote

Cognizant North America
life insurance, parental leave, paid time off, paid holidays, 401(k)
United States, Pennsylvania, Malvern
Mar 08, 2025

Applications will be accepted until 03/10/2025

About Us:

Cognizant is one of the world's leading professional services companies, we help our clients modernize technology, reinvent processes and transform experiences, so they can stay ahead in our constantly evolving world. Cognizant is looking to expand our team and your skills are needed! Are you interested? If so, please apply in order to be considered. We look forward to reviewing your application!

Job Overview:

We are looking for a dedicated Customer Service Representative that handles phone inquiries related to benefits, eligibility, and claims for various healthcare plans. They resolve issues by researching and collaborating with other departments, engage with customers, and document call specifics. The role also involves working with vendors, responding to member correspondence, and orienting new members. Additional duties include supporting team development and participating in projects. Strong multitasking and communication skills are essential.

Are you truly service oriented? Do you know how to take care of people?

Job Responsibilities:

Handle inbound phone inquiries related to:

  • Member Benefits and Eligibility: HMO, EPO/PPO, Medicare and Medicaid, CHP, and FHP product lines.
  • Provider Benefits and Claims: Eligibility, PEP and claim status, member pharmacy calls, prior approval skills (ACP/DME and CCD), and routine outbound calls.
  • Issue Resolution: Research documentation, system information, and collaborate with other employees, management, or departments to resolve benefits and eligibility issues.
  • Customer Interaction: Engage with customers, document call specifics, and demonstrate quality program behaviors to create outstanding relationships with each caller.
  • Vendor Collaboration: Work with outside vendors as needed to answer questions or resolve issues.
  • Member Correspondence: Respond to member correspondence and emails using existing CSS system letters to effectively address member concerns.
  • New Member Orientation: Provide an overview of the member's plan and relevant administrative policies to new members.
Secondary Responsibilities:
  • Team Development: Demonstrate awareness, motivation, and technical skills to assist in the growth of the customer service teams and identify process improvements.
  • Project Assistance: Participate in department and company projects as needed, providing feedback about the customer's experience.
Education and Experience:
  • Must pass a background check.
  • High School Diploma and Equivalent Experience
  • Must be computer literate and able to multi-task, including documenting call experiences while utilizing the Quality Program.
  • Excellent communication and interpersonal skills.
Salary and Other Compensation:

The hourly rate for this position is $16-$18 an hour, dependent on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant's discretionary annual incentive program, based on performance and subject to the terms of Cognizant's applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

  • Medical/Dental/Vision/Life Insurance
  • Paid holidays plus Paid Time Off
  • 401(k) plan and contributions
  • Long-term/Short-term Disability
  • Paid Parental Leave
  • Employee Stock Purchase Plan

Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Cognizant is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.

If you have a disability that requires a reasonable accommodation to search for a job opening or submit an application, please email CareersNA2@cognizant.com with your request and contact information. Applications are accepted on an ongoing basis.

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