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We are looking for a compassionate and detail-oriented Medical Customer Service Rep to support members with health plan questions in Minneapolis, Minnesota. This Long-term Contract position is ideal for someone who thrives in a fast-paced call center setting and can deliver clear, accurate guidance related to benefits, claims, and member services. The person in this role will help create a positive experience for members by resolving concerns efficiently and connecting them with the appropriate healthcare resources.
Job Responsibility
Handle incoming calls from health plan members and provide clear explanations related to coverage, benefits, and claim status
Assist callers with questions about amounts owed, including billing concerns and statements issued by healthcare providers
Review member eligibility details and help individuals understand Medicaid-related services and managed care plan information
Guide members through provider network options so they can identify appropriate participating healthcare professionals and facilities
Explain medical authorization guidelines and help members understand when prior approval may be required for certain services
Support members with coordinating transportation arrangements and navigating scheduling options tied to their health plan benefits
Document customer interactions thoroughly and maintain accurate records of inquiries, actions taken, and follow-up needs
Deliver empathetic, high-quality service while meeting standards in a high-volume customer support environment
Requirements
Previous experience in a call center or customer service role, preferably within healthcare or health insurance
Working knowledge of Medicaid, Medicaid eligibility, claims processing, and member service practices
Familiarity with prior authorization processes and provider network navigation
Strong verbal communication skills with the ability to explain complex benefit information in a simple, helpful manner
Comfortable managing a high volume of calls while maintaining accuracy, professionalism, and attention to detail
Ability to document information clearly and use customer service systems efficiently
Proven ability to handle sensitive situations with patience, discretion, and a member-focused approach