Customer Service Associate Representative

Role overview

This position supports plan participants, client contacts, and healthcare providers with questions about group health benefits and claim payments. The associate is also expected to investigate claim-related issues, keep detailed records of interactions, and step in to help teammates when needed.

Key duties

• Handle incoming phone inquiries from members, employer contacts, and providers about benefits and claim status.
• Respond with accurate, timely, and easy-to-understand information.
• Record every call in Chronolog with a concise summary of the conversation.
• Respond to messages left in assigned voicemail inboxes.
• Review, understand, and apply plan documents, amendments, and client updates across multiple accounts.
• Meet with clients when support is needed to clarify questions about their health benefit plans.
• Assist colleagues and partner teams whenever requested.
• Track faxed claims and enter fax details into Chronolog.
• Route misdirected claims back to the correct provider.
• Help members use the website and related self-service tools.
• Work to company targets for quality and productivity.
• Be consistently punctual and dependable in attendance.
• Assist with claim research and identifying claim details.
• Support maintenance of provider records.
• Index claim batches and correspondence batches.
• Carry out assignments tied to specific client groups.
• Assist with employee onboarding, training, and cross-training.
• Prepare documentation related to refunds and reimbursement issues.

Quality expectations

Performance is measured against company standards for output, service quality, and audit results, and the role is expected to meet or surpass those benchmarks consistently.

Education and experience

A high school diploma or GED is required. Previous exposure to customer service work and basic computer use is expected.

Technical and communication requirements

• Strong verbal and written communication skills.
• Comfort using a PC environment, including Windows, Word, and Adobe Acrobat, with the ability to learn new systems quickly.
• Typing speed of at least 45 words per minute.
• Good listening ability and careful attention to detail.
• Basic math skills.
• Strong interpersonal skills and a collaborative working style.
• Ability to organize, retain, and recall large volumes of detailed information.
• Capability to read, interpret, and apply benefit plans, insurance materials, and regulations.
• Professional conduct and the ability to present a positive image in every work setting.
• Commitment to protecting privacy and maintaining confidentiality.
• Ability to stay composed under pressure and work to deadlines.
• Strong troubleshooting skills, along with patience and professionalism.

Work-from-home setup

If the role is performed from home, whether occasionally or full-time, the internet connection must come from a cable broadband or fiber optic provider and provide at least 10 Mbps download and 5 Mbps upload speed.

Compensation and benefits

The expected pay range for this position is USD 17.75 to 19 per hour, depending on relevant factors such as experience and location. The role is also expected to be eligible for an annual bonus plan.

Benefits begin on day one and include medical, vision, dental, behavioral health and well-being programs, a 401(k), company-paid life insurance, tuition reimbursement, at least 18 days of paid time off each year, paid holidays, and leaves of absence.

About the employer

Allegiance by Cigna Healthcare has been administering medical benefits since 1981, with services that include claim processing, customer service, utilization management, and case management. The organization uses a high-touch service model to support innovative health benefit programs for members and clients.

Equal opportunity notice

All qualified candidates are considered without discrimination based on race, color, age, disability, sex, pregnancy or childbirth-related conditions including lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or family status, genetic information, public assistance status, or citizenship status.