Customer Service Specialist

Healthesystems

. Build trusted relationships with clients, claimants, and pharmacies by providing superior customer service to every caller .

Posted 10/30/2026full-timeRemote • United StatesJunior💰 $19 per hourWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates strong customer service skills in the healthcare industry, effectively resolving inquiries related to claims adjudication and Pharmacy Benefit Management while maintaining professionalism and compassion. Proficient in using Windows-based applications and multitasking in a fast-paced environment.

Highest-signal resume keywords

Customer Service ExperienceClaims Adjudication KnowledgePharmacy Benefit ManagementHealthcare Industry ExperienceVerbal And Written Communication

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Claims AdjudicationPharmacy Benefit ManagementEligibility VerificationPrior AuthorizationBilling VerificationKeyboard Data EntryReading Prescription Drug NamesMultitasking With Dual MonitorsComprehending Simple InstructionsWriting Short Correspondence

Soft Skills

Problem-SolvingAttention To DetailPatienceProfessionalismCompassion

Tools & Technologies

Windows-Based Applications

Industry Keywords

HealthcareCustomer ServiceAdministrative EnvironmentAttendance GuidelinesQuality Guidelines

About the role

Key responsibilities & impact

Build trusted relationships with clients, claimants, and pharmacies by providing superior customer service to every caller
Resolve phone inquiries related to claims adjudication, eligibility verification, prior authorization, Pharmacy Benefit Management, Ancillary Benefits Management, and some Billing Verification Department functions
Work with Team Lead, Supervisor, and Manager to resolve customer inquiries
Use verbal and written communication, listening, organizational, problem-solving, and reasoning skills
Adhere to attendance, punctuality, and quality guidelines
Translate jargon and complex processes into simple, step-by-step instructions
Handle difficult customers and situations with attention to detail, patience, professionalism, and compassion
Adapt communication approach to different member styles and personalities
Take initiative and assume responsibility where appropriate

Requirements

What you’ll need

High school diploma or general education degree (GED) and one to two years related customer service and/or healthcare experience required; or equivalent combination of education and experience
Reliable, high speed internet access with sufficient bandwidth
Private workspace free from distraction and noise
Knowledge of Windows-based applications
Ability to multitask with dual monitors
Ability to swiftly enter information using a keyboard
Ability to read prescription drug names
Ability to comprehend simple instructions
Ability to write short correspondence/memos
Prior experience in an administrative business environment highly preferred
Experience in the healthcare industry preferred
Flexibility to work varying or rotating shifts, overtime, weekends, and holidays as necessary

Benefits

Comp & perks

Work-From-Home model
Healthcare coverage
PTO
Paid holidays
401(k)
Company-provided life insurance/disability coverage
Wellness options/resources
Company laptop provided
Recognition programs
Dental insurance
Vision insurance
Statutory benefits, including Colorado HFWA
Travel to attend meetings and visit locations throughout the country may be required