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Health Plan Customer Service Representative Jobs

Customer Service Representative

Las Vegas, NV · On-site

$15.25 - $20.75/hr

Educate merchants on service offerings and help them proactively plan to minimize issues * Support merchant's projects and assist throughout their lifecycle * The Customer Service Representative will ...

Customer Service Rep

Newark, NJ · On-site

$16.75 - $22.75/hr

The CSR will report to the Director of Customer Care. * The position is based on a 40 hour work ... Plan with company match Paid Time Off (PTO) Vacation, Personal and Sick Days

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Health Plan Customer Service Representative information

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$9

$18

$26

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

As of Jul 16, 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.

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.
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:
Infographic showing various Health Plan Customer Service Representative job openings in the United States as of July 2026, with employment types broken down into 78% Full Time, 20% Part Time, and 2% Contract. Highlights an 90% Physical, 1% Hybrid, and 9% Remote job distribution, with an average salary of $39,098 per year, or $18.8 per hour.
Customer Service Representative

Customer Service Representative

Independent Health Association

Buffalo, NY • On-site, Remote

$19/hr

Full-time

PTO

Posted 23 days ago


Independent Health rating

7.6

Company rating: 7.6 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

190th of 281 rated insurance


Job description

FIND YOUR FUTURE

We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

We're excited to announce an excellent opportunity for full-time Customer Service Representatives starting on September 8th, 2026.

Training:

  • Approximately 10 weeks of paid, on-site training

  • Monday-Friday, 8:00AM - 4:30pm

  • Location: 250 Essjay Rd., Williamsville, NY

Schedule:

  • After training, this role transitions to a hybrid work arrangement

  • You'll be assigned a regular shift between 8:00 AM and 8:00 PM

  • Shift Preferences will be discussed after training

  • Occasional Overtime may be required, including holidays and weekends, based on business needs

Pay Rate:

  • $19 per hour

Overview

The Customer Service Representative (CSR) is responsible for displaying confidence, passion for service, and practicing empathetic listening while connecting to Independent Health members. The CSR actively listens, assesses needs and utilizes system tools and resources to address and resolve inquiries. In addition, the CSR makes appropriate process or regulatory determinations and follows escalation procedures when deemed appropriate. The CSR is called on to research complex issues pertaining to benefits, claims, plans, and eligibility across multiple databases which requires fluency in computer navigation and toggling while confidently and compassionately engaging with the member.

Qualifications
  • High school diploma or GED required.
  • Prior experience and success working in a customer service focused environment required.
  • Previous experience working in a call center preferred.
  • Knowledge of CPT codes, ICD-9 coding, and medical terminology preferred.
  • Excellent written and verbal communication skills. Ability to communicate with internal and external customers effectively and efficiently. Must be able to work collaboratively.
  • Ability to think critically and listen with intent to understand.
  • Ability to adapt behavior based on constructive feedback to improve job performance.
  • Proficient in problem solving and ability to prioritize accordingly.
  • Microsoft Office experience required with the ability to talk and type simultaneously. Must demonstrate proficiency in balancing keyboard accuracy with speed, the ability to correctly transmit data, and the ability to work efficiently while producing excellent customer service experiences.
  • Strong organizational and time management skills.
  • Ability to assume responsibility and maintain confidentiality. Strong sense of accountability is required.
  • Flexibility to work additional hours as required by department. Flexibility in shift assignment required. Must have availability to work a shift between 8:00 a.m. and 8:00 p.m. during normal business hours. Weekend shifts and holidays may occasionally be required.
  • Ability and willingness to meet with customers face to face at alternate locations when business needs require.
  • Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.
Essential Accountabilities

Service Customers

  • Provide excellent customer service when responding to customers and de-escalate customers as needed.
  • Relay accurate and up-to-date information on policies and procedures and communicate a successful resolution to inquiries.
  • Document all calls accurately and timely.
  • Escalate issues to the appropriate resources as outlined in policy and procedure guides.
  • Meet or exceed all quality, productivity, accuracy, and call identification goals as stated in the most current departmental policy.

Maintain Core Knowledge

  • Maintain technical knowledge regarding Independent Health's contracts and benefits and working knowledge of policies, procedures, and updates daily.
  • Attend required training sessions as needed (including remote and onsite learning).
  • Provide accurate and up-to-date information to all customers by documenting all pertinent information into appropriate systems to meet regulatory agency standards.

Technology Requirements

  • Utilize multiple systems and tools to obtain needed information related, but not limited to:
    • Claims.
    • Enrollment.
    • Authorizations.
    • Finance.
    • Accounts Receivable.
    • Reference Screens.
    • Providers.
  • Ability to determine claim status and whether claim is adjudicated properly. Must have knowledge and ability to make claim adjustments using established criteria.

Immigration or work visa sponsorship will not be provided for this position

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant's race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub app.


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