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Health Plan Customer Service Representative Jobs

Sword Health

Director, Health Plan Customer Success

$187K - $295K/yr

At Sword, we're building AI to heal billions and unlock humanity's full potential. In doing so, we're pioneering AI Care, a fundamentally new approach to healthcare built for medical reasoning,

Transcarent

OR

About this role At Transcarent client relationships are our top priority. The Manager, Health Plan Partnership Success, is responsible for supporting existing Health Plan strategic partnerships.

Works Plumbing

CSR / Customer Service Rep

Pacifica, CA · On-site

$18 - $25/hr

Works Plumbing of Pacifica, CA, is to fill part-time and full-time CSR / Customer Service Representative positions to handle client calls regarding their plumbing needs, discuss them with the

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Health Plan Customer Service Representative information

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How much do health plan customer service representative jobs pay per hour?

As of Jun 17, 2026, the average hourly pay for health plan customer service representative in the United States is $18.80, according to ZipRecruiter salary data. Most workers in this role earn between $15.38 and $20.91 per hour, depending on experience, location, and employer.

What are the key skills and qualifications needed to thrive as a Health Plan Customer Service Representative, and why are they important?

To thrive as a Health Plan Customer Service Representative, you need strong knowledge of health insurance policies, benefits administration, and customer service practices, typically supported by a high school diploma or equivalent. Familiarity with customer relationship management (CRM) software, claims processing systems, and Microsoft Office Suite is commonly required. Outstanding communication, patience, problem-solving, and conflict resolution skills help representatives effectively assist members and address their concerns. These abilities are crucial for delivering accurate information, ensuring customer satisfaction, and maintaining the reputation of the health plan provider.

How much does a 215 license make?

A Health Plan Customer Service Representative with a 215 license, which typically refers to a health insurance license, can expect to earn an average salary ranging from $35,000 to $50,000 annually, depending on experience and location. Licensing may be required for handling certain insurance products and customer inquiries in the health insurance industry.

What jobs pay 2000 a day?

Jobs that can pay $2,000 a day typically include high-level roles such as specialized medical professionals, senior corporate executives, or successful entrepreneurs. These positions often require advanced skills, extensive experience, or significant responsibilities, and may involve consulting, legal work, or investment activities. Such high daily earnings are uncommon and usually associated with top-tier expertise or ownership of profitable businesses.

How to become a healthcare customer service representative?

To become a healthcare customer service representative, candidates typically need a high school diploma or equivalent and strong communication skills. Relevant experience in customer service or familiarity with healthcare terminology can be beneficial, and some employers may require certification in healthcare billing or insurance. Proficiency with computer systems and customer management software is also important.

What does a Health Plan Customer Service Representative do?

A Health Plan Customer Service Representative assists members with questions about their health insurance coverage, benefits, and claims. They handle inquiries by phone, email, or chat, providing information about plan details, helping resolve billing or coverage issues, and guiding members through enrollment or policy changes. Their goal is to ensure members understand their health plan options and receive timely, accurate support.

What are some common challenges Health Plan Customer Service Representatives face when assisting members, and how can these be managed effectively?

Health Plan Customer Service Representatives often encounter challenges such as addressing complex benefit questions, resolving billing or claims disputes, and managing high call volumes during peak periods. To handle these effectively, representatives rely on strong communication skills, in-depth knowledge of plan details, and efficient use of support resources like knowledge bases and escalation protocols. Additionally, staying patient and empathetic helps in building trust with members and ensuring positive outcomes, even in stressful situations.

What do healthcare customer service representatives do?

Healthcare customer service representatives assist patients with questions about their health plans, benefits, and coverage. They handle inquiries, resolve issues, update patient information, and often use computer systems to document interactions and access account details.
More about Health Plan Customer Service Representative jobs
What cities are hiring for Health Plan Customer Service Representative jobs? Cities with the most Health Plan Customer Service Representative job openings:
What states have the most Health Plan Customer Service Representative jobs? States with the most job openings for Health Plan Customer Service Representative jobs include:
What job categories do people searching Health Plan Customer Service Representative jobs look for? The top searched job categories for Health Plan Customer Service Representative jobs are:
Health Plan Customer Service Representative jobs near you
Infographic showing various Health Plan Customer Service Representative job openings in the United States as of June 2026, with employment types broken down into 1% As Needed, 82% Full Time, and 17% Part Time. Highlights an 94% Physical, 1% Hybrid, and 5% Remote job distribution, with an average salary of $39,098 per year, or $18.8 per hour.
Director, Health Plan Customer Success

Director, Health Plan Customer Success

Sword Health

Remote

$187K - $295K/yr

Full-time

Medical, Dental, Vision, Life, Retirement, PTO

Posted 25 days ago

Job description

At Sword, we're building AI to heal billions and unlock humanity's full potential. In doing so, we're pioneering AI Care, a fundamentally new approach to healthcare built for medical reasoning, safety, and real-time treatment, not generic technology applied after the fact. As both a clinical-centric frontier AI lab and an applied AI platform, Sword is reimagining how care is delivered at scale, removing traditional barriers like appointments, waiting rooms, and stigma so more people can access the care they need-and ultimately get back to lives lived in full.
Since 2020, Sword has expanded across physical therapy, women's health, cardiometabolic, and mental health, and is now moving beyond the session to a fully AI-native, 24/7 care program that brings physical activity, therapeutic exercise, psychotherapy, nutrition, and behavior change into one connected experience. More than 700,000 members across three continents have completed over 10 million AI sessions, helping 1,000+ enterprise clients avoid more than $1 billion in unnecessary healthcare costs. Backed by 42 clinical studies, 44+ patents, and more than $500 million raised from leading investors including Khosla Ventures, General Catalyst, and Founders Fund, Sword is defining a new standard for healthcare.
Sword Health is seeking a Director of Health Plan Customer Success to lead our health plan and payor partnership success function. This is a senior commercial leadership role with direct accountability for GRR, NRR, and relationship outcomes across a portfolio of major health plan accounts, and for leading a team of approximately eight Health Plan Customer Success professionals. The right candidate brings deep familiarity with hoe health plans evaluate and sustain clinical vendor partnerships, a commercial orientation towards retention and expansion, and the leadership instinct to drive a team to its highest performance.
AI Proficiency at Sword Health
AI fluency is a core expectation at Sword Health. Every candidate is assessed against our three-level framework - be ready to share real examples of how AI is already part of how you work.
  • Explorer (Level 1) - Uses AI daily to boost personal productivity
  • Builder (Level 2) - Creates workflows and tools that elevate the whole team
  • Integrator (Level 3) - Embeds AI into products and processes at scale

Every hire must demonstrate at least Level 1. The expected level will vary depending on the seniority of the role.
What you'll be doing:
  • Own GRR and NRR across the health plan segment, partnering with Sword's Health Plans commercial team on renewals and new account integration.
  • Lead a team of approximately eight Health Plan CSMs and Advisors to the highest performance standards: coaching continuously, developing talent, and acting decisively when someone is not meeting the bar.
  • Serve as the executive relationship owner with health plan stakeholders, including medical directors, VP Contracting, and network leadership.
  • Evolve the health plan CS operating model: mature how the team manages accounts, runs renewals, and delivers client reviews -- building on an existing foundation and raising the bar.
  • Drive cross-functional collaboration with Product, GMs, Implementation, and Clinical to solve client problems and deliver on commitments.
  • Translate member outcomes and program performance into business-impact narratives that land with plan-level leadership.

What you need to have:
  • Prior people leadership: you have set high performance standards, developed talent, and made hard calls when someone is not meeting the bar.
  • Commercial accountability mindset: you measure success in retention and expansion outcomes, not relationship quality.
  • Strong analytical and critical thinking foundation: you reason from facts and data, synthesize clearly, and communicate with brevity in writing and in conversation.
  • High initiative and sound judgment: you identify what matters, act without waiting to be directed, and build influence across functions to drive outcomes.
  • Experience working with, within, or in service of health plans, payors, or health systems, whether in account management, commercial strategy, operations, or consulting.

To ensure you feel good solving a big Human problem, we offer:
  • A stimulating, fast-paced environment with lots of room for creativity
  • A bright future at a promising high-tech startup company
  • Career development and growth, with a competitive salary
  • The opportunity to work with a talented team and to add real value to an innovative solution with the potential to change the future of healthcare
  • A flexible environment where you can control your hours (remotely) with unlimited vacation
  • Access to our health and well-being program (digital therapist sessions)
  • Remote or Hybrid work policy
  • To get to know more about our Tech Stack, check here.

$187,810 - $295,130 a year
*This range includes base, variable and equity
These compensation bands are just the starting point. Once someone joins and proves they're outlier talent, we adjust quickly to ensure their compensation aligns with their impact.
Our job titles may span more than one career level. Actual pay is determined by skills, qualifications, experience, location, market demand, and other factors. Compensation details listed in this posting reflect the base salary and any potential variable, bonus or sales incentives, and the Company's estimation of the value of private company stock options, if applicable. The pay range is subject to change, future value of company stock options is not guaranteed, and compensation may be modified in the future. In addition to our total compensation, Sword offers a number of benefits as listed below.
*This range includes base, variable and equity.
These compensation bands are just the starting point. Once someone joins and proves they're outlier talent, we adjust quickly to ensure their compensation aligns with their impact.
Our job titles may span more than one career level. Actual pay is determined by skills, qualifications, experience, location, market demand, and other factors. Compensation details listed in this posting reflect the base salary and any potential variable, bonus or sales incentives, and the Company's estimation of the value of private company stock options, if applicable. The pay range is subject to change, future value of company stock options is not guaranteed, and compensation may be modified in the future. In addition to our total compensation, Sword offers a number of benefits as listed below.
US - Sword Benefits & Perks:
• Comprehensive health, dental and vision insurance*
• Life and AD&D Insurance*
• Financial advisory services*
• Supplemental Insurance Benefits (Accident, Hospital and Critical Illness)*
• Health Savings Account*
• Equity shares*
• Discretionary PTO plan*
• Parental leave*
• 401(k)
• Flexible working hours
• Remote-first company
• Paid company holidays
• Free digital therapist for you and your family
*Eligibility: Full-time employees regularly working 25+ hours per week
Note: Applicants must have a legal right to work in the United States, and immigration or work visa sponsorship will not be provided.
SWORD Health, which includes SWORD Health, Inc. and Sword Health Professionals (consisting of Sword Health Care Providers, P.A., SWORD Health Care Providers of NJ, P.C., SWORD Health Care Physical Therapy Providers of CA, P.C.*) complies with applicable Federal and State civil rights laws and does not discriminate on the basis of Age, Ancestry, Color, Citizenship, Gender, Gender expression, Gender identity, Gender information, Marital status, Medical condition, National origin, Physical or mental disability, Pregnancy, Race, Religion, Caste, Sexual orientation, and Veteran status.
We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.

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