Concierge Customer Service Representative II

About This Opportunity

We are representing a confidential healthcare organization seeking a Concierge Customer Service Representative II for a remote position in the United States. This is a critical senior-level customer service role that requires excellent customer interaction skills combined with critical thinking abilities. Our client operates in the health benefits administration space, and this position plays a vital role in supporting members and healthcare providers with complex inquiries and precertification needs.

The ideal candidate will be versatile and equipped with a strong skill set to handle the complexity of servicing both member inquiries and provider communications while maintaining the highest standards of professionalism and accuracy.

Responsibilities

• Respond to telephone and email inquiries from members and providers within defined service standards
• Negotiate with healthcare providers to gain acceptance for plans without network agreements and out-of-network providers
• Assist members with health benefits and healthcare-related questions
• Document all customer interactions in system-based call logs with accuracy and completeness
• Handle incoming precertification calls including case initiation, status updates, and appropriate call routing
• Make outbound calls for demonstrations, case completion information gathering, and network steerage redirection
• Process incoming electronic precertification requests
• Verify and correct patient and provider demographic information as needed

What We're Looking For

Required Experience:

• Minimum two years of customer service or call center experience in a healthcare-related role
• High school diploma or G.E.D. required; Associate degree or higher preferred

Required Skills:

• Strong customer relations and interpersonal skills with the ability to handle confidential and sensitive information
• Proficiency with Microsoft applications and strong computer navigation abilities
• Excellent data entry and typing skills
• Knowledge of medical terminology
• Strong attention to detail and analytical skills
• Excellent verbal and written communication skills
• Ability to exercise independent judgment in decision making and problem solving
• Patience and ability to handle difficult situations tactfully and diplomatically
• Ability to multi-task and anticipate potential needs and problems
• Proven ability to build relationships with internal and external customers

Preferred Qualifications:

• Medical intake experience
• Understanding of self-funded health benefits
• Health payor background in the self-funded industry
• Knowledge of provider organizations and networks
• Knowledge and understanding of CMS Medicare reimbursement rates
• Ability to effectively negotiate rate structures
• Claim processing skills
• Insurance verification or precertification experience
• Provider office, facility billing, or financial department experience
• Third-party administrator (TPA) experience
• Bilingual capabilities

Work Environment: This is a remote position requiring a home office setup. The role involves prolonged sitting in front of a computer with hand-eye coordination and manual dexterity sufficient to operate standard office and computer equipment. Occasional high-stress situations may occur when dealing with customers and clients.

How We Work With You

Our talent team at Get A Job.ai partners with exceptional healthcare organizations to connect them with qualified professionals. When you apply through our platform, a dedicated recruiter will review your qualifications and conduct an initial screening. If there's a strong match, we'll submit your profile to our client for consideration. Please note that direct contact with the client is not permitted during the application process—all communication flows through Get A Job.ai to ensure a professional and organized experience for everyone involved.

Pay

Pay via Get A Job.ai will be discussed during the screening process and is competitive with industry standards for this level of healthcare customer service expertise.

Equal Opportunity: Get A Job.ai is committed to equal employment opportunity and does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, veteran status, or any other protected characteristic under applicable law.