Customer Service Representative I

Community Health Plan of Washington

. Respond to member and provider inquiries regarding benefits, eligibility, claim status, and related issues .

Posted 10/28/2026full-timeRemote • Washington • United StatesJunior💰 $21 - $29 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in customer service within the healthcare sector, particularly with Washington Apple Health and medical terminology. Proficient in resolving inquiries and documenting information accurately while maintaining high standards of communication and attention to detail.

Highest-signal resume keywords

Washington Apple Health KnowledgeCustomer Service ExperienceMedical Terminology KnowledgeMS Office ProficiencyAnalytical Problem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Customer ServiceCall Center ExperienceBenefit InterpretationEligibility AssessmentData Documentation

Soft Skills

Excellent Communication SkillsAttention to DetailAbility to Prioritize TasksCritical Thinking

Tools & Technologies

MS OfficeOutlookWordExcel

Certifications & Qualifications

Criminal Background Check Clearance

Industry Keywords

Managed CareHealthcareInsuranceProvider Setting

About the role

Key responsibilities & impact

Respond to member and provider inquiries regarding benefits, eligibility, claim status, and related issues
Provide information and facilitate or coordinate appropriate resolutions
Provide first-call resolution for inquiries regarding benefit interpretation, eligibility, access to care through plan providers, and related issues under Washington Apple Health, Cascade Select Plans, and other CHPW products
Document inquiries, complaints, and other data accurately, clearly, and promptly in a computer database
Meet attendance and call-quality standards
Perform job functions accurately, with attention to detail, within established timeframes
Perform other duties as assigned

Requirements

What you’ll need

Knowledge of Washington Apple Health state medical insurance
Knowledge of medical terminology and healthcare
Minimum of one (1) year of customer service and/or call center experience, preferably in insurance, managed care, or a provider setting
Comfortable working in a 100% remote environment
Ability to gather and assess information from multiple systems, apply protocols, and determine appropriate actions
Ability to use MS Office products such as Outlook, Word, and Excel
Excellent verbal and written communication skills, including typing
Must complete and successfully pass a criminal background check
Must not be sanctioned or excluded from participation in federal or state healthcare programs
Vaccination requirement, with medical or religious exemptions available
Ability to learn and prioritize multiple tasks and handle demanding situations
Analytical, problem-solving, and critical-thinking ability

Benefits

Comp & perks

Eligible for overtime
5% annual incentive target based on company, department, and individual performance goals
Medical, Prescription, Dental, and Vision
Telehealth app
Flexible Spending Accounts
Health Savings Accounts
Basic Life AD&D
Short- and Long-Term Disability
Voluntary Life, Critical Care, and Long-Term Care Insurance
401(k) Retirement and generous employer match
Employee Assistance Program and Mental Fitness app
Financial Coaching
Identity Theft Protection
PTO accrual starting at 17 days per year
40 hours Community Service volunteer time
10 standard holidays
2 floating holidays
Compassion time off
Jury duty leave
Medical or religious vaccination exemptions process
Reasonable accommodation for disabilities