Customer Service Representative

About the Role

At Premera Blue Cross, we believe that health care should be easy to navigate and member-focused. We are seeking a dedicated and empathetic Customer Service Representative to join our remote workforce. In this pivotal role, you will serve as the primary point of contact for our members, acting as a trusted advocate who helps them understand their benefits, resolve complex billing inquiries, and access the care they need. This is an opportunity to do meaningful work that directly impacts the well-being of our community while enjoying the flexibility of a 100% telecommuter environment.

• Act as the first point of contact for members, providers, and employer groups, handling high-volume inbound inquiries via phone and digital channels with professionalism and care.
• Translate complex insurance terminology and policy details into clear, easy-to-understand information for our members.
• Research and resolve inquiries regarding claims status, coverage eligibility, provider networks, and pharmacy benefits.
• Document all member interactions accurately within our internal CRM system to ensure continuity of care and service.
• Collaborate with internal departments, including billing and clinical teams, to advocate for member needs and resolve escalated issues.
• Maintain high levels of accuracy and efficiency while adhering to HIPAA regulations and company privacy standards.
• Continuously stay updated on plan changes, industry regulations, and internal process improvements to provide the most accurate information possible.

• A high school diploma or GED equivalent is required; an Associate’s or Bachelor’s degree is preferred.
• Previous experience in customer service, retail, or a call center environment, preferably within the healthcare or insurance industry.
• Excellent verbal and written communication skills with the ability to convey empathy and patience.
• Strong problem-solving skills and the ability to think critically while navigating multiple software systems simultaneously.
• Demonstrated ability to work independently in a remote setting while maintaining high productivity and meeting performance metrics.
• A quiet, secure home office space with a high-speed internet connection.
• A commitment to Premera’s mission of improving lives and providing world-class service to our diverse member base.

• Competitive hourly pay with opportunities for performance-based advancement.
• Comprehensive medical, dental, and vision insurance coverage starting shortly after your hire date.
• Generous Paid Time Off (PTO) and paid holidays to support a healthy work-life balance.
• 401(k) retirement savings plan with a company matching contribution.
• Tuition reimbursement and ongoing professional development opportunities.
• A fully remote work environment with equipment provided by the company.
• A supportive culture that values diversity, equity, and inclusion in every aspect of the organization.

Required Skills