Customer Service Representative - Healthcare
Milwaukee Succeeds, Goerkes Corner, WI, United States
Customer Service Representative – Healthcare
About the Role: We are seeking a
Member Experience Representative
to support members, providers, customers, and brokers by answering questions related to coverage, claims, benefits, billing, and authorizations. This role is highly customer‑focused and ideal for individuals with healthcare, insurance, and call‑center experience who enjoy helping others navigate complex information in a clear and friendly way.
Location: Remote within Wisconsin. Hybrid option available in Brookfield or Menasha, WI. Schedule: Monday‑Friday, 8:00 AM – 4:30 PM. Role is fully remote to start; after conversion becomes hybrid. Candidates must be located in Wisconsin and able to pick up equipment onsite.
Key Responsibilities
Answer inbound phone and email inquiries from members, providers, customers, and brokers regarding coverage and benefits, claim status, billing questions, and prior authorizations.
Investigate member accounts and take appropriate next steps to resolve concerns.
Translate healthcare and insurance terminology into simple, easy‑to‑understand explanations.
Document all interactions clearly and accurately within internal systems.
Ask probing and clarifying questions during calls to ensure
first call resolution .
Follow up with internal departments or external resources to resolve outstanding issues.
Escalate complex or sensitive issues to a supervisor or appropriate team when needed.
Adhere to organizational policies, regulatory requirements, and HIPAA standards.
Consistently meet department performance metrics and response time standards.
Demonstrate behaviors aligned with Network Health's mission, values, and commitment to service.
Required Qualifications
2+ years of healthcare customer service or call‑center experience.
Experience with insurance verification, explanation of benefits (EOBs), and prior authorizations.
Strong verbal and written communication skills.
Excellent attention to detail and organizational skills.
Job Type & Location
This is a Contract to Hire position based out of Brookfield, WI.
Pay and Benefits
Pay range: $18.25 – $18.25/hr.
Medical, dental & vision
Critical illness, accident, and hospital
401(k) retirement plan – pre‑tax and Roth post‑tax contributions available
Life insurance (voluntary life & AD&D for employee and dependents)
Short and long‑term disability
Health spending account (HSA)
Transportation benefits
Employee assistance program
Time off/leave (PTO, vacation or sick leave)
Application Deadline
This position is anticipated to close on Apr 30, 2026.
Equal Opportunity Employer
The company is an equal‑opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.
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About the Role: We are seeking a
Member Experience Representative
to support members, providers, customers, and brokers by answering questions related to coverage, claims, benefits, billing, and authorizations. This role is highly customer‑focused and ideal for individuals with healthcare, insurance, and call‑center experience who enjoy helping others navigate complex information in a clear and friendly way.
Location: Remote within Wisconsin. Hybrid option available in Brookfield or Menasha, WI. Schedule: Monday‑Friday, 8:00 AM – 4:30 PM. Role is fully remote to start; after conversion becomes hybrid. Candidates must be located in Wisconsin and able to pick up equipment onsite.
Key Responsibilities
Answer inbound phone and email inquiries from members, providers, customers, and brokers regarding coverage and benefits, claim status, billing questions, and prior authorizations.
Investigate member accounts and take appropriate next steps to resolve concerns.
Translate healthcare and insurance terminology into simple, easy‑to‑understand explanations.
Document all interactions clearly and accurately within internal systems.
Ask probing and clarifying questions during calls to ensure
first call resolution .
Follow up with internal departments or external resources to resolve outstanding issues.
Escalate complex or sensitive issues to a supervisor or appropriate team when needed.
Adhere to organizational policies, regulatory requirements, and HIPAA standards.
Consistently meet department performance metrics and response time standards.
Demonstrate behaviors aligned with Network Health's mission, values, and commitment to service.
Required Qualifications
2+ years of healthcare customer service or call‑center experience.
Experience with insurance verification, explanation of benefits (EOBs), and prior authorizations.
Strong verbal and written communication skills.
Excellent attention to detail and organizational skills.
Job Type & Location
This is a Contract to Hire position based out of Brookfield, WI.
Pay and Benefits
Pay range: $18.25 – $18.25/hr.
Medical, dental & vision
Critical illness, accident, and hospital
401(k) retirement plan – pre‑tax and Roth post‑tax contributions available
Life insurance (voluntary life & AD&D for employee and dependents)
Short and long‑term disability
Health spending account (HSA)
Transportation benefits
Employee assistance program
Time off/leave (PTO, vacation or sick leave)
Application Deadline
This position is anticipated to close on Apr 30, 2026.
Equal Opportunity Employer
The company is an equal‑opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information, or any characteristic protected by law.
#J-18808-Ljbffr