Job Information
Robert Half Medical Customer Service Representative in Troy, Michigan
Description
Position Overview:
We are actively seeking a dedicated, empathetic, and detail-oriented Medical Customer Service Representative to become part of our Call Center team. In this role, you will serve as the first point of contact for members, healthcare providers, and prospective customers, providing timely and accurate information about pre-authorizations, claim statuses, benefits, and network providers. Your goal will be to ensure exceptional customer satisfaction by handling inquiries professionally and resolving issues effectively. This contract-to-hire position has remote flexibility, offering a great balance for motivated individuals.
Primary Responsibilities:
Accurately address customer inquiries by phone or email, including those from policyholders, beneficiaries, and healthcare providers.
Provide detailed explanations related to benefits, claim statuses, pre-authorizations for medical services, co-payment information, and provider networks.
Download and use various systems for information tracking, troubleshooting, and documentation purposes.
Maintain accurate records by completing documentation and tracking all inquiries within internal systems.
Stay current with ongoing updates to healthcare plans and internal processes.
Collaborate with managers and escalate unresolved queries or complaints for additional support.
Employ critical thinking skills to address complex issues and navigate sensitive situations, ensuring the highest level of professionalism is maintained.
Resolve inquiries quickly while managing irate or anxious customers with empathy and tact.
Consistently adhere to HIPAA guidelines and standards, ensuring the confidentiality of sensitive data.
Requirements
Required Skills and Experience:
Familiarity with CPT codes, HCPCS, diagnosis codes, and ADA codes is essential.
1+ years of experience related to medical benefits, claims, and eligibility.
Proven experience in high-volume call center environment, preferably in healthcare industry.
Efficient in computer systems, strong typing skills, and familiarity with basic software tools.
Must possess outstanding verbal and written communication skills to convey complex information effectively.
Ability to manage large amounts of information accurately and meet deadlines consistently.
Ability to remain calm and solution-focused in stressful or fast-paced scenarios.
High-speed internet access, with a private HIPAA compliant workspace
Apply Now:
If you possess the required healthcare knowledge, communication skills, and customer-first mindset, submit your application today to become a valued part of our team as a Medical Customer Service Representative!
TalentMatch®
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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.
© 2025 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .