Healthcare Customer Service Representative - High-Stress Environment

Healthcare in the U.S. is an ever-changing maze filled with confusion and complexity. Amaze Health is a company dedicated to empowering our patients with all the tools, resources, and medical support they need to take charge of their own healthcare. We don’t just take care of people, we partner with them. Join our innovative team as we change healthcare in America, one patient at a time.

We are seeking a resilient, empathetic, and highly skilled Healthcare Customer Service Representative to join our team. This role is ideal for individuals who have thrived in challenging environments such as ACA Marketplace or Medicare plan sales call centers, and who are adept at managing high volumes of calls from frustrated or confused customers.

You will be the frontline voice for patients and members navigating complex healthcare systems, insurance coverage, and billing issues. Your ability to remain calm, professional, and solution-oriented in the face of anger, confusion, or misinformation will be critical to your success.

Ideal Candidate Profile

You’ve worked in places where the phones never stop ringing, the systems crash mid-call, and the customers are often angry before you even say hello. You know how to listen, how to calm someone down, and how to find answers even when the tools don’t work. You’re not just looking for a job—you’re looking for a place where your grit and grace are valued.

Key Responsibilities

• Handle inbound and outbound calls related to health insurance plans, billing inquiries, coverage disputes, and care coordination.
• De-escalate emotionally charged situations with empathy and professionalism.
• Educate members on ACA Marketplace and Medicare plan options, eligibility, and benefits.
• Resolve complaints, process cancellations, and troubleshoot service issues.
• Maintain accurate documentation of all interactions in CRM and EHR systems.
• Collaborate with internal departments to resolve complex issues.
• Stay current on federal and state healthcare regulations, especially ACA and Medicare updates.
• Meet performance metrics including call resolution time, customer satisfaction scores, and compliance standards.

Requirements

• Minimum 2 years of experience in a healthcare call center, preferably in ACA Marketplace or Medicare sales/support.
• Proven ability to handle high call volumes and irate customers.
• Strong verbal and written communication skills.
• Familiarity with HIPAA regulations and handling PHI.
• Proficiency in CRM and EHR systems (e.g., Epic, Salesforce).
• High school diploma or equivalent; college coursework in healthcare or communications preferred.

Preferred Qualifications

• Experience working in environments with poor infrastructure or limited support.
• Background in outbound sales or retention for health plans.
• Bilingual (Spanish/English) highly desirable.
• Certification in customer service or healthcare administration.

Benefits

This position is a full time benefited role. Amaze offers a comprehensive benefit plan to include medical, dental and vision insurance, 401K, and paid time off.

Pay Range for this position is $26/hr - $30/hr