Customer Service Agent

Point C Health is a National third-party administrator (TPA) specializing in self-funded benefit programs. They focus on innovative solutions like network and payment integrity, pharmacy benefits, and care management to drive down plan costs.

The Customer Service Agent will correspond with callers to provide benefit information, claim status, or general health plan information based on the schedule of benefits. Training is conducted remotely, and upon completion, the role is fully remote. The schedule varies but typically falls between 8:00 am to 8:00 pm, Monday–Friday, Eastern Time.

Primary Responsibilities:

• Create a welcoming experience by authentically engaging every caller.
• Engage in friendly and genuine conversations to provide a world-class customer experience.
• Interact with team members and coworkers in a supportive and purpose-driven environment.
• Thoroughly and accurately answer questions about customers’ healthcare accounts.
• Listen thoughtfully to callers’ needs and provide appropriate solutions.
• Demonstrate a culture of ethical conduct, safety, and compliance.
• Handle 35–50+ inbound and outbound phone calls per day.
• Collaborate closely with claim staff to make warranted adjustments to claims.
• Perform other duties as needed based on business requirements.

Qualifications:

• 2+ years of customer service experience; 1+ years in a TPA or payer setting.
• Experience with self-funded plans is preferred.
• A Bachelor’s degree or medical billing/coding certification.
• Additional TPA or payer experience.
• Strong communication, multitasking, and computer skills (Microsoft Office).
• Ability to work remotely and handle prolonged computer-based tasks.