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Call Center Professionals / Customer Service Associates

EmblemHealth
United States, Connecticut, Farmington
Mar 14, 2025


*** Must be able to commute to work location at 195 Scott Swamp Road, Farmington, CT 06302***

We are seeking dynamic Call Center Professionals to join our Call Center in Farmington, CT!

Our Call Center professionals provide telephonic customer service support to members, providers and facilities. Handle incoming inquiries through multiple contact channels and effectively and efficiently communicate resolutions to members' requests ensuring high First Contact Resolution. The Call Center team advocates for our members in the event there are issues and follows up with the members once the issues are resolved.

If you believe in extraordinary commitment to customer service, come join us!

***All positions are on-site at 195 Scott Swamp Road, Farmington, CT 06302***

Essential Job Information:



  • 8 weeks of in-classroom training onsite
  • Primarily sedentary


Compensation and Benefits:



  • Hourly Pay Rate is $19.23
  • We offer competitive health and wellness benefits


Job Responsibilities:



  • Proactively receive and respond clearly to telephone calls and correspondence from members regarding billing, benefits, coverage, payment, coding, and health services policies and procedures.
  • Demonstrate a customer service attitude on the initial call with a commitment to resolve customer issues including claims, benefit and enrollment inquiries through health plan navigation and collaboration with other internal groups.
  • Function as a scheduling agent, working in collaboration with the member, to ensure appointments are scheduled, as necessary.
  • Maintain telephone log documenting number, content and type of calls received.
  • Explain medical pre-authorization requirements and disposition of pre-authorization requests, as necessary.
  • Research and analyze recurring billing and eligibility problems/complaints to determine root causes and trends.
  • Provides instruction to members for submitting out-of-plan medical claims.
  • Investigate requests for claims adjustments by members and collaborates with internal teams to ensure adjustments are made.
  • Inform and educate members on how to utilize self service capabilities and functionality with the portals and mobile application.
  • Gather and proactively provide feedback to stakeholders based on member feedback to further improve customer experience.


Required Qualifications:



  • High School degree or equivalent
  • Up to 2 years of customer service experience
  • Microsoft office experience; with keyboarding and basic computer proficiency
  • Strong customer service skills
  • Excellent written and communication skills
  • Strong problem-solving and multi-tasking skills
  • Ability to collaborate and work effectively within a team environment


Preferred Qualifications:



  • Associate or higher degree
  • Up to 2 years of call center experience in healthcare industry
  • Bi-lingual Spanish

Additional Information


  • Requisition ID: 2500J
  • Hiring Range: $19.23 per hour

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