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Posted: 10/16/2026Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates strong customer service skills with the ability to effectively communicate and resolve issues while maintaining compliance with HIPAA regulations. Proficient in managing customer interactions and administrative tasks to ensure high-quality service delivery.
Highest-signal resume keywords
Customer Service ExperienceHIPAA ComplianceProblem-Solving SkillsCommunication ProficiencyMultitasking Ability
About the role
Key responsibilities & impact- Provide effective customer service to internal and external customers
- Use in-depth knowledge of company products and programs to assist customers
- Confer with customers by telephone regarding Rx claims processing
- Maintain detailed records of customer interactions and transactions
- Follow up to ensure appropriate changes resolve customer problems
- Refer unresolved customer grievances to designated departments
- Review Rx insurance policy terms to determine claim coverage for employer groups
- Contact customers regarding inquiries, claim investigation results, or planned adjustments
- Resolve customer service and billing complaints
- Examine relevant information to assess complaint validity and causes
- Protect and report issues involving HIPAA-protected health information
- Attend and demonstrate competency in required HIPAA training
- Perform other assigned duties as business needs change
Requirements
What you’ll need- High School or equivalent
- Customer service experience
- Computer experience
- Knowledge of principles and processes for providing customer and personal services
- Ability to use computers and computer systems
- Ability to communicate with supervisors, peers, subordinates, customers, and external contacts by telephone, email, in writing, or in person
- Ability to obtain, process, calculate, audit, and verify information and data
- Ability to handle complaints, settle disputes, and resolve grievances
- Ability to organize, plan, prioritize, and manage time
- Ability to perform administrative activities and maintain information files
- Problem-solving and analytical skills
- Communication proficiency
- Teamwork orientation
- Technical capacity
- Multitasking ability
- Flexibility to work assigned shifts, including call center operating hours
- Availability for rotating on-call responsibilities
- Ability to comply with HIPAA obligations and complete required HIPAA training
Benefits
Comp & perks- Equal employment opportunity and nondiscrimination protections
- HIPAA training provided by the company
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Data ProcessingClaims ProcessingAdministrative ActivitiesInformation VerificationRecord Maintenance
Soft Skills
Teamwork OrientationFlexibilityOrganizational SkillsAnalytical SkillsConflict Resolution
Tools & Technologies
Computer SystemsEmail CommunicationTelephone Communication
Certifications & Qualifications
HIPAA Training
Industry Keywords
Customer InteractionBilling ComplaintsInsurance Policy TermsGrievance ResolutionCall Center Operations