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Job Overview
Location
Work From Home (HB)
Job Type
Full-time
Category
Software Engineering
Date Posted
December 23, 2025
Full Job Description
đź“‹ Description
- • Be the reassuring voice that guides employees, members, and providers through the complexities of COBRA and self-funded health benefits. Every call you answer is an opportunity to turn confusion into clarity and anxiety into confidence.
- • Own the full lifecycle of customer inquiries—phone, email, and chat—covering benefits, eligibility, claim status, claim disposition, and more. You are the single point of accountability from first contact to final resolution.
- • Navigate up to 10 concurrent system screens and proprietary platforms without missing a beat. Your ability to toggle between knowledge bases, claims systems, and plan documents in real time keeps average handle time low and first-call resolution high.
- • Document every interaction with surgical precision inside Salesforce, SharePoint, and internal case-tracking tools. Your notes become the legal record that protects members, providers, and the organization.
- • Translate dense Summary Plan Documents (SPDs), insurance booklets, and regulatory language into plain-English explanations that anyone can understand. You are the bridge between legal jargon and human empathy.
- • Detect patterns in recurring issues and escalate systemic problems to Quality, Training, and IT teams. Your frontline observations directly influence process improvements and system enhancements.
- • Meet or exceed performance metrics: 90% quality score, ≤5% transfer rate, ≥85% first-call resolution, and customer satisfaction ≥4.5/5. You thrive in a performance-measured environment where data drives recognition and advancement.
- • Participate in twice-weekly calibration sessions and monthly continuing-education webinars on COBRA regulations, HIPAA updates, and new product rollouts. Your growth plan is curated by L&D specialists and tied to career paths in Workforce Management, Training, or Compliance.
- • Maintain a distraction-free, HIPAA-compliant home workspace with hard-wired Ethernet and dual monitors. You are the guardian of PHI and the first line of defense against cyber threats.
- • Collaborate with a fully remote yet tightly knit team across 13 states. Daily huddles, instant-message pods, and virtual coffee chats keep culture alive even when miles apart.
🎯 Requirements
- • High-school diploma or GED plus a minimum of 1 year customer service experience in any industry
- • Demonstrated ability to work in a fast-paced, high-volume call center environment with structured schedules and performance metrics
- • Excellent verbal, written, and interpersonal communication skills; able to de-escalate and resolve issues in real time
- • Proficiency with MS Office (Excel, Word) and proven ability to learn new proprietary systems quickly
- • Must reside in and be authorized to work in one of the following states: IL, IN, IA, KS, MO, MT, NM, NC, OK, PA, TN, TX, or WI; sponsorship is not available
🏖️ Benefits
- • Work-from-home flexibility with a one-time home-office stipend and monthly internet reimbursement
- • Comprehensive total-rewards package: medical, dental, vision, 401(k) with match, pension plan, paid parental leave, disability, and supplemental life insurance
- • Annual incentive bonus tied to individual and team performance metrics
- • Robust tuition reimbursement and curated development plans that map to internal career paths in Training, Quality, Compliance, and Workforce Management
Skills & Technologies
About Health Care Service Corporation
Health Care Service Corporation is the largest customer-owned health insurer in the United States, operating Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma, and Texas. It provides medical, dental, vision, life, and disability coverage to nearly 17 million members through individual, employer, and government programs. The company emphasizes community health investments, digital services, and value-based care initiatives. Founded in 1936 and headquartered in Chicago, HCSC is licensed as a mutual legal reserve company and governed by its policyholders.
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