Healthcare Customer Service Associate

About the role

Fusion CX is seeking a Healthcare Customer Service Associate to be the primary point of contact for members seeking assistance with benefits, eligibility, referrals, and claims. The role involves handling high call volumes while delivering compassionate, accurate support.

Key responsibilities

• Respond to inbound calls and written inquiries about healthcare benefits, eligibility, referrals, and claims.
• Investigate concerns, identify root causes, and provide accurate resolutions.
• Escalate complex or unresolved issues to management or appropriate departments.
• Maintain ownership of inquiries through resolution and ensure a positive member experience.
• Document interactions thoroughly in internal systems and adhere to departmental policies.

Required profile

• High School Diploma or equivalent.
• 1‑2 years of call‑center or customer‑service experience (2 years preferred).
• Experience with Medicare benefits, especially Medicare Advantage, is preferred.
• Fluent in English and Spanish at a business‑level.
• Ability to remain calm and professional in high‑stress situations.

Required skills

• Data entry and general computer skills (word processing, email).
• Effective oral and written communication.
• Professional telephone etiquette.

What we offer

• Comprehensive training and ongoing development opportunities.
• Collaborative and inclusive work environment.
• Career advancement within a global CX transformation company.