Customer Service Representative

Capital Blue Cross

. Provide efficient, courteous, and professional service to members, providers, group administrators, brokers, Plan personnel, and the general public .

Posted 10/15/2026full-timeRemote • Pennsylvania • United StatesJunior💰 $17 - $31 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong customer service skills with the ability to analyze inquiries and provide accurate information while maintaining compliance with HIPAA regulations. Proficient in using communication tools and software to support effective interactions and issue resolution.

Highest-signal resume keywords

Customer Service ExperienceHIPAA ComplianceAnalytical SkillsVerbal and Written Communication SkillsMicrosoft Office Suite

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Inquiry AnalysisPolicy InterpretationIssue ResolutionData EntryProblem-Solving

Soft Skills

FlexibilityIndependenceProfessionalismOrganization

Tools & Technologies

Facets SystemInquiry Control SystemInteractive Voice ResponseAutomated Call Distribution

Certifications & Qualifications

High School DiplomaG.E.D.

Industry Keywords

Protected Health InformationCustomer SatisfactionMarketing SupportEnrollmentBillingClaims

Tech Stack

Tools & technologies

React

About the role

Key responsibilities & impact

Provide efficient, courteous, and professional service to members, providers, group administrators, brokers, Plan personnel, and the general public
Handle inquiries via telephone, fax, written correspondence, email, internet messenger, and personal interviews
Research and analyze customer inquiries involving enrollment, billing, benefits, and claims
Review and interpret applicable policies and procedures to determine appropriate actions
Resolve routine and moderately complex inquiries across all lines of business administered and supported by Capital BlueCross
Provide clear instructions to appropriate Plan areas for issue resolution
Contact internal and external entities to obtain information and initiate necessary action
Respond to customers verbally or in writing with accurate and timely information
Monitor inquiries for timely and accurate resolution and customer satisfaction
Enter and update information in the Facets system or Inquiry Control System
Report inquiry trends to management
Support Marketing personnel and brokers by researching and communicating customer information
Participate in marketing activities such as health fairs, seminars, open enrollment, and on-site visits

Requirements

What you’ll need

High school diploma or G.E.D.
1 year customer service experience
Ability to understand and interpret detailed policies and procedures and apply them to various situations
Thorough understanding of responsibility to maintain privacy of Protected Health Information as required by HIPAA
Ability to work independently, be flexible, and react appropriately to changing job assignments and work environments
Effective and professional verbal and written communication skills
Analytical, organization, and problem-solving skills
Ability to use telephone equipment systems such as Interactive Voice Response and Automated Call Distribution
Familiarity with a PC and software such as Microsoft Office Suite
Ability to perform sedentary work involving significant periods of sitting, talking, hearing, keying, and repetitive motions

Benefits

Comp & perks

Medical, Dental & Vision coverage
Retirement Plan
Paid Time Off
Holidays
Volunteer time off
Incentive Plan
Tuition Reimbursement
Flexible work environment
Training and continuing education
Opportunities to volunteer in the community