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Customer Service Representative-Clinical

Job Details

American Specialty Health Incorporated is seeking a Customer Service Representative to join our Customer Service-Clinical department.

The primary function of this position is to answer incoming calls from Providers, Members and Health Plans. The calls are focused on assisting callers with a wide range of topics from benefit information to problem resolution.

Full-time regular employees: starting pay at $15/hour with potential of $16/hour within first year, plus merit. Additional bonus opportunities based on meeting Key Job Accountabilities (KJA) after 6, 12 and 24 months.

Remote Worker Guidelines

Remote Worker Guidelines: This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet connection must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher quality video meetings.

Responsibilities

Receives and responds to incoming telephone calls.
- Answer incoming calls and outgoing calls in a professional, accurate, timely and courteous manner.
- Communicates professionally at all times.
- Ascertain the nature of the call and record information in the ASH proprietary systems.
- Look up caller information using proprietary ASH systems and provide information to the caller.
- Forward logs requiring further research to the appropriate department.
- Utilize appropriate resources, including those online; to provide timely responses.
- Manage time to ensure calls are answered within required timeframes and appropriate follow up is done in a timely
  manner.
- Meet or exceed minimum key job accountabilities established for the Customer Service Representative position.
- Maintains safe, secure, and healthy work environment by following all legal and compliance requirements.
- Complete all ASH and CSS trainings timely.
Attends weekly staff and other meetings to discuss issues and foster teamwork among department personnel.
- Responds to requests for internal and external customers and/or clients, as required.
Performs other duties as assigned.
Complies with all policies and standards.

Qualifications

High School Diploma or GED certificate required.
1 year experience performing customer service duties; inbound call center experience preferred.
Basic computer skills.
Strong verbal communication skills.
Ability to utilize and maneuver in multiple systems during a single interaction.

Core Competencies

Demonstrated ability to interact in a positive, respectful manner and establish and maintain cooperative working relationships.
Ability to display excellent customer service to meet the needs and expectations of both internal and external customers.
Excellent listening and interpersonal communication skills to identify critical core competencies based on success factors and organizational environment.
Ability to effectively organize, prioritize, multi-task and manage time.
Demonstrated accuracy and productivity in a changing environment with constant interruptions.
Demonstrated ability to analyze information, problems, issues, situations, and procedures to develop effective solutions.
Ability to exercise strict confidentiality in all matters.

APPLY HERE: Customer Service Representative-Clinical

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Member Navigator

Job Details

As a Member Navigator, you’ll serve as a primary non-clinical point of contact for members, providing end-to-end support across assigned healthcare programs and services. You’ll help members navigate their experience by answering questions, explaining program benefits and processes, gathering and verifying required information, researching and resolving routine issues, coordinating appointments and services, and ensuring timely follow-up through resolution. You’ll collaborate with members, providers, clients, clinical teams, and internal business partners to facilitate timely access to care and deliver a seamless member experience. You’ll also maintain accurate case documentation, identify and address barriers, escalate complex or clinical matters to the appropriate resources, and provide support across programs and workflows as business needs evolve.

Things You’ll Do Here:

Serve as a primary point of contact for members through phone, email, and other communication channels, providing timely, professional, and compassionate assistance.
Educate members regarding applicable programs, benefits, processes, eligibility requirements, available services, provider options, and next steps.
Gather, verify, and accurately document demographic information, eligibility information, benefit information, referrals, service needs, and other information required to support the member’s case.
Research member, provider, or client questions using available systems, resources, and established program guidelines; resolve routine issues independently and escalate complex, clinical, or non-standard matters appropriately.
Coordinate the end-to-end scheduling process for imaging and other applicable healthcare services, including identifying appropriate providers, facilitating appointments, confirming scheduling details, and communicating updates to members and providers.
Coordinate with Case Management, clinical staff, or other internal teams when a member requires clinical review, surgical support, additional care coordination, or services outside the Navigator’s non-clinical scope.
Manage assigned member cases through appropriate resolution, including monitoring progress, conducting follow-up, identifying barriers to service, and coordinating next steps with the appropriate stakeholders.
Maintain complete and accurate documentation of member interactions, case activity, scheduling information, outcomes, and follow-up requirements in applicable CRM, scheduling, case management, and other departmental systems.
Facilitate effective communication among members, providers, clients, clinical teams, and internal departments to support timely service delivery and a positive member experience.
Build and maintain productive working relationships with provider facilities and other external partners.
Identify service issues, potential escalations, or barriers to timely care and take appropriate action within established procedures to support resolution.
Assist with claims-related, administrative, and operational activities associated with member cases as needed.
Meet established quality, productivity, service level, documentation, and member experience expectations.
Maintain working knowledge of assigned programs, processes, systems, and business initiatives and successfully cross-train across supported workflows.
Flex between programs, queues, and work types based on volume and business needs.
Collaborate with team members and cross-functional partners to identify opportunities to improve workflows, operational efficiency, and the member experience.
Perform other duties as assigned.

Reasonable accommodation may be made to enable individuals with disabilities to perform essential duties.

What You’ll Bring to the Team:

2+ years of experience working in a remote, call center environment.
High-school diploma or GED.
Experience in healthcare scheduling, patient/member access, healthcare operations, customer service, insurance, medical office operations, or another related support environment.
High attention to detail while maintaining courteous, accurate, and timely relations with our partners and members.
Experience working independently and completing assignments within given instructions, routines, and accepted practices.
Experience in a customer service focused and deadline driven environment.
Excellent verbal and written communication skills.
Experience with Microsoft Office Suite to include Excel and PowerPoint.
Experience communicating complex information effectively.

A plus if you have…

Associate’s degree
Background in healthcare combined with medical, claims, or collection call center experience.
Medical Terminology Certification
Experience reading, interpreting, and explaining Explanation of Benefits (EOBs).
BCPA Certification.

APPLY HERE: Member Navigator

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HR Customer Service Rep High Volume Call Center

Job Details

This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).

Current Scheduling needs: 8a-4:30p CST or 2:30p-11p CST, rotating weekends

Experience the HCA Healthcare difference where colleagues are trusted, valued members of our healthcare team. Grow your career with an organization committed to delivering respectful, compassionate care, and where the unique and intrinsic worth of each individual is recognized. Submit your application for the opportunity below: CSR Tier I WFH

Job Summary and Qualifications

The HRSC Tier I Customer Service Representative will perform administrative, and data/records management activities in support of HR and HRIS functions, including interpreting life-cycle reports, onboarding, status change, compensation, separations, etc. The HRSC Customer Support Tier I Representative will work under direction from the HRSC Supervisor to ensure HR service delivery is consistently high-quality.

In this role you will:

Provides customer service by answering HRAnswers calls, documents all customer inquiries and resolutions received via phone calls. Ask HR, Chat, mailboxes or alternative streams of input in order to identify, diagnose, and initiate research necessary to resolve customer issues in a timely manner, as needed
Provides support within a HR Line of Business
Cleary communicates problem symptoms and consults with CS Tier 2 representatives as necessary to aide in resolving customer issues/requests and ensure all pertinent information is included
Escalate unresolved issues as needed
Perform any other duties as needed
Provide assistance on navigating internal resources on self-service and HR technology tools

Qualifications:

Strong Customer Service skills
1 year of experience in HR preferred
Previous call center experience preferred
Virtual employees are required to have high speed interview with 25 MB download and15 MB upload
Remote employees are required to live within a 60 mile radius of an HCA Hospital

APPLY HERE: HR Customer Service Rep High Volume Call Center

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Import Specialist II

Job Details

This is a remote role, supporting our New York team, that follows a Monday through Friday schedule of 8:00AM to 5:00PM EST.

The primary responsibility of this position is to process and integrate customer data, assisting with the movement of goods between international borders.

Job Description:

Serves as the customer service liaison between the company and the customer(s)
Resolves problems (i.e. billing, tracking shipments) and handles customer concerns. Builds relationships with customers
Prepares important documents for import customs clearance of client shipments (i.e. bonds, bills, classify/release and reports), including PGAs.
Traces shipments and re-routes freight accordingly.
Communicates and corresponds with CBP and the various PGAs to resolve routine issues.
Prepares import documents including: bills of lading, dock receipts, licenses, and consulate documents and distributes documents to all appropriate parties.
Cross-trains in additional responsibilities.
Handles confidential information.
Has experience specific to client submission requirements and clearance of specific commodities
Opens files, enters notes, information and document requests in corporate systems
Reviews documentation or issues documents to meet government regulations and carrier regulations
Convert and verify shipment weight, volume and foreign currency
Sends information/document requests to company’s employees, suppliers, service providers and/or U.S. government agencies as needed
Communicates with specific offices, departments, and teams on all issues affecting customs brokerage
Ensures compliance with regards to U.S. Government regulatory agencies such as FDA, EPA, USFWS, etc.
Maintains communication with customers, carriers and vendors
Coordinates shipments from airline, ocean piers and CFS (container freight station) to customer/consignee destination
Coordinates pick-ups and invoices files
Stays up-to-date on regulations, laws, guidelines and Deringer requirements. Acts as a resource to internal and external clients.
Handles accounting processes accurately and in a timely manner
Performs additional duties as assigned by management.

Required Qualifications:

High school diploma/GED
3+ of recent customs brokerage experience

The hourly compensation for this position ranges from $20.00 to $30.00, depending on experience and education.

*To ensure competitive and equitable compensation, pay may vary based on the candidate’s regional market compensation rates.

APPLY HERE: Import Specialist II

Service Desk Specialist

Job Details

Certara accelerates the potential of bringing medicines to market and to patients using biosimulation software, technology, and services to transform traditional drug discovery and development. Our clients include more than 2,400 biopharmaceutical companies, academic institutions, and regulatory agencies across 70 countries.

Our goal is to enable the life sciences industry’s use of data, modeling, and analytics to make better decisions across the various phases of discovery and drug development. Our software and scientists incorporate modern advances in scientific understanding, drug development experience, data analysis, and AI resulting in significant opportunities to decrease the cost and increase the probability of success for new drug approval and commercialization.

As a Service Desk Specialist at Certara, you are responsible for the delivery of high quality and timely responses to our customers and users. Under the direction of the Support Lead, you’ll collaborate closely with our internal teams to distribute issues and requests to appropriate resources for efficient resolution and drive a positive customer experience in each interaction with our Service Desk.

Responsibilities

Monitor, triage, and respond to all the tickets created internally and externally
Follow through each ticket from creation to true resolution
Advocate on behalf of customers to ensure their ideas and feedback are communicated and responded to accordingly
Contribute to the management of the end-to-end support process and continue to find opportunities in order to improve customer experience
Collaborate closely with other teams, i.e. Product, Engineering, QA, Customer Success
Maintain the technical user knowledge center by documenting best practices
Inform Product on feature ideas and help prioritize tickets
Notify Product when customers consistently struggle in specific areas
Escalate to Customer Success Managers when there are potential risks

Qualifications

• 1+ years of experience in a customer facing application support role
• Have strong experience with ticketing and CRM software such as JIRA
• Have ability to independently drive a positive customer experience by quickly responding to and resolving incidents/requests
• Have strong communication and collaboration skills
• Be able to get things done efficiently
• Experience working within software development and understanding of the Software Development Life Cycle (SDLC method)
• Proven track record of developing and meeting/exceeding SLAs and Support Desk deliverables
• Ability to conduct research into a wide range of technical issues
• Strong interpersonal, communication, writing, presentation and facilitation skills
• Detail-oriented, with exceptional follow-through and superior organizational skills
• Ability to communicate with technical teams (e.g. developers and engineers) effectively to drive effective issue resolution
• Experience in working on multi-client projects with competing priorities

Candidates who live on the East Coast of the United States

APPLY HERE: Service Desk Specialist

Telephone Counselor Associate (Remote – Texas Residents)

Job Details

***Candidates must reside in Texas to be considered for this position.***

Successful candidates will start employment with TRS effective October 15, 2026, and must report in-person to our Austin Mueller office that day for New Employee Orientation.

As part of the interview process, selected applicants will be asked to complete a pre-interview assessment along with a short video interview. The assessment and link to the interview will be emailed to the applicant. Instructions for each will be included in separate emails. If selected, final candidates must be available for an extended virtual interview and call simulation.

Telephone Counselor Associates provide benefit counseling services to members and others in an on-the-job training environment and will proactively work with the Contact Center team, Pension Services staff, and agency employees.

Telephone Counselor Associates participate in a formal classroom training program and spend time with an on-the-job training (OJT) coach before answering phone calls on their own. During the initial classroom training, work hours are 8:00 AM (CST) to 5:00 PM (CST), Monday through Friday. Member Services hours of operation are 7:00 AM (CST) to 6:00 PM (CST). After training, regular shifts may begin between 8:30 AM (CST) and 9:30 AM (CST), based on business needs, and include a 30-minute lunch. Closing requires handling calls remaining in queue after 6:00 PM (CST).

WHAT YOU WILL DO:

Benefit Counseling
• Participates in the TRS Benefit Counseling training program.
• Counsels members and assists school district officials regarding the full range of TRS benefit options.
• Explains benefit options, including eligibility requirements and limitations, and provides general information and referral services on related benefit programs such as Social Security and Medicare.
• Resolves and responds to telephone inquiries and complaints.
• May research and resolve complaints and problems regarding service and disability requirements, projected benefits, health benefits, refunds, death benefits, purchase of special services, post retirements, district reporting requirements, agency forms, and other issues.
• Determines and explains benefit options and associated taxes.
• Determines, recommends, and implements appropriate actions to resolve issues and process member requests, including informing and making recommendations to members and school district officials on necessary measures.
• Interprets and explains applicable TRS rules, regulations, policies, procedures, processes, and forms.
• Receives and processes requests for informational booklets and forms.
• Documents and maintains member records by updating information into the computer database, including collecting and recording accurate notes for member files.

Performs related work as assigned.

WHAT YOU WILL BRING:

Required Education
• High school diploma or GED.
• Education and experience may substitute for one another.

Required Experience
• One (1) year of full-time experience in a call center, contact center, banking, accounting, claims processing, benefit processing, or other customer service related experience involving interpreting, applying, and communicating complex laws, regulations, and policies.
• Navigating and using computer systems and applications, such as Microsoft Office and virtual meeting software.

Preferred Qualifications
• Associate’s or Bachelor’s degree from an accredited college or university.
• Experience interpreting, applying, and communicating complex laws, regulations, policies, and procedures.
• Experience providing in-person customer service in financial services, pension benefits, or health insurance.
• Experience with Claims processing or benefits processing.
• Bilingual in English and Spanish.

Knowledge of
• TRS benefit programs.
• Modern office practices, systems, and equipment.

Skill in
• Interpreting, explaining, and applying complex laws, regulations, policies, and procedures.
• Planning, organizing, and prioritizing work assignments to manage a high-volume workload in a fast-paced and changing environment, completing detailed work accurately.
• Analyzing problems and devising effective solutions.
• Using a computer in a Microsoft Windows environment with word processing, SharePoint, and other business software.
• Effective written and verbal communication, including telephone communication and active listening skills.
• Providing quality customer service.
• Efficiently and accurately documenting information into various computer systems.

Ability To

• Provide member support by telephone and written channels, including secure messages, for prolonged periods, in a high-volume contact center environment.
• Establish and maintain harmonious working relationships with co-workers, agency staff, TRS members, school district officials, and other contacts and work effectively in a professional team environment.
• Work occasional overtime, weekends, or extended hours as needed to manage the team workload.

APPLY HERE: Telephone Counselor Associate (Remote – Texas Residents)

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