Customer Service Representative I - Claims, Geisinger Health Plan (Pennsylvania

Remote•Remote

Full-timeRemoteremotejobsorg

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About this role

Location: Work from home (Pennsylvania)Shift: Days (United States of America)Scheduled Weekly Hours: 40Worker Type: RegularExemption Status: NoJob Summary: Assists in resolving customer concerns, providing appropriate education/instruction and maintaining customer satisfaction by providing the highest level of customer service in only one of the Primary Functions. Actively participates in cross training, improving processes within the Customer Service team.Job Duties:

Determines if services received are covered benefits as applicable by line of business and product design.
Reviews suspended claims for resolution by applying current policies, procedures and benefits applicable to specific products.
Provides team building resources to assist in directing peers to proper claims resolution policies and procedures in order to assist members and providers.
Provides daily support and advice to member and provider services staff regarding claims issues.
Researches claim issues from participating providers and identifies specific criteria for reconsideration for payment. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying with all organization policies and procedures. The specific statements in this profile are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job. Position Details: Education: High School Diploma or Equivalent (GED)- (Required)Experience: Minimum of 1 year-Customer Service (Required)Certification(s) and License(s): Skills: Communication, Customer Retentions, Customer Service OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities.
KINDNESS: We strive to treat everyone as we would hope to be treated ourselves.
EXCELLENCE: We treasure colleagues who humbly strive for excellence.

Posting details

Remote

Yes

Employment type

Full-time

Workplace type

Remote

Source

remotejobsorg

First seen

10/9/2026, 8:10:27 AM

Last seen

10/9/2026, 8:10:27 AM