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HealthEdge

Call Center Agent II

HealthEdge

. Receive and respond to inbound phone calls for customer assistance .

Posted 9/18/2026full-timeRemote • MexicoJuniorMid-LevelWebsite

Core Competencies

Role fit
Core Competencies

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

Demonstrates expertise in Healthcare Claims Operations and Call Center Customer Service, ensuring high-quality customer interactions and effective problem resolution. Proficient in managing customer inquiries and documentation while maintaining attention to detail and compliance with coding and reimbursement policies.

Highest-signal resume keywords
Healthcare Claims OperationsCall Center Customer ServiceVerbal and Written Communication SkillsMS Office ProficiencySpanish Language Proficiency

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills
Healthcare ClaimsCoding and Reimbursement PoliciesTicketing and Tracking SystemsData ResearchCustomer Inquiry Response
Soft Skills
Attention to DetailProblem-Solving SkillsMinimal Supervision
Tools & Technologies
MS Office ApplicationsPrimary Payor Systems
Industry Keywords
Customer AssistanceClaims Department LiaisonInbound and Outbound CallsHybrid Work Environment

About the role

Key responsibilities & impact
  • Receive and respond to inbound phone calls for customer assistance
  • Respond to outbound phone call requests
  • Document all calls in ticketing and tracking systems
  • Respond to customer inquiries and provide data within required time frames
  • Act as liaison between claims department and providers
  • Research customer claims in primary payor systems
  • Ensure the highest level of customer service on every call
  • Perform other duties as assigned or necessary
  • Work across multiple time zones in a hybrid or remote work environment

Requirements

What you’ll need
  • High school degree required; Bachelor’s degree preferred
  • 2-3+ years of relevant professional experience in Healthcare claims operations or 2-3+ years of relevant experience in a Call Center environment
  • Previous Health Care Call Center/Customer Service Experience
  • Must be able to work with minimal supervision
  • Comprehensive understanding of covered benefits, coding and reimbursement policies and contracts
  • Excellent verbal and written communication skills
  • Attention to detail and problem-solving skills
  • Proficiency with MS Office applications, especially Word and Excel
  • Spanish speaking and written language proficiency preferred
  • Candidates may be required to complete a pre-employment criminal background check

Benefits

Comp & perks
  • Full-time, permanent employment
  • Remote work environment
  • May require travel dependent on company needs
  • Reasonable accommodations for individuals with disabilities
  • Equal opportunity employment