Health Insurance Customer Service Representative (CSR)

Job Title: Health Insurance Customer Service Representative (CSR)

Are you looking for a rewarding career where you can help people every day? Do you thrive in a friendly, team-oriented environment where your hard work is valued and rewarded? Pinnacle Insurance, a trusted agency with over 50 years of experience, is looking for a Health Insurance Customer Service Representative to be the voice of our company and provide top-tier service to our valued clients.

If you have a great personality, love helping people, and want to work for a company that puts its employees and clients first, this is the opportunity for you!

Job Summary:

The Health Insurance Customer Service Representative (CSR) serves as the primary point of contact for members, providers, and internal departments regarding health insurance inquiries. This role is responsible for resolving questions related to coverage, claims, billing, and plan benefits while ensuring exceptional customer experiences and maintaining regulatory compliance.

What You’ll Do:

• Handle inbound and outbound calls, emails, , providers, and agents regarding health insurance coverage and services.
• Explain policy coverage, benefits, eligibility, authorizations, and claim status clearly and accurately.
• Assist members with billing issues, premium payments, and plan changes or renewals.
• Process requests such as ID card replacements, address updates, and account verifications.
• Document all interactions in the company’s CRM or member services platform.
• Ensure compliance with HIPAA and other applicable insurance regulations.
• Educate members on preventive care, health programs, and cost-saving options within their plan.
• Meet or exceed performance goals in areas such as customer satisfaction, call quality, and issue resolution time.

What We’re Looking For:

• A positive attitude and passion for helping others
• High school diploma or equivalent required; associate or bachelor’s degree in business, healthcare administration, or a related field preferred.
• 3 years of customer service experience in a health insurance or managed care setting strongly preferred.
• Knowledge of insurance terminology claims processing, and health plan structures (HMO, PPO, etc.).
• Excellent verbal and written communication skills.
• Strong problem-solving and organizational skills.
• Proficiency with Microsoft Office and customer service software.
• Bilingual skills (especially Spanish) are a plus.

Why Join Us?

• Competitive pay: $22 - $25 per hour
• Monday to Friday 9 AM – 5 PM
• On-site
• Growth opportunities in a thriving agency.
• Supportive, team-oriented work environment.

Job Type: Full-time

Pay: $22.00 - $25.00 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• On-the-job training
• Paid time off
• Professional development assistance
• Referral program
• Vision insurance

Shift:

• 8 hour shift
• Day shift

Ability to Commute:

• West Jordan, UT 84088 (Required)

Ability to Relocate:

• West Jordan, UT 84088: Relocate before starting work (Required)

Work Location: In person

Salary : $22 - $25