Customer Service Representative I - Claims, Geisinger Health Plan (Pennsylvania resident)
- Source: Geisinger
- Geisinger
- Remote
- United States
- Full-Time
- Mid level
Job Description
Location Work from Home Job Category Member Services, Geisinger Health Plan Schedule Days Work Type Full time Department GHP Customer Care Team Date posted 10/06/2026 Job ID R-10995
Job 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.
Education
High School Diploma or Equivalent (GED)- (Required)
Experience
Minimum of 1 year-Customer Service (Required)
Skills
Customer Retentions; Communication; Customer Service
About Geisinger
Founded more than 100 years ago by Abigail Geisinger, the system now includes ten hospital campuses, a 550,000-member health plan, two research centers and the Geisinger Commonwealth School of Medicine. With nearly 24,000 employees and more than 1,700 employed physicians, Geisinger boosts its hometown economies in Pennsylvania by billions of dollars annually. Learn more at geisinger.org or connect with us on Facebook, Instagram, LinkedIn and Twitter.
Equal Opportunity Employer
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, pregnancy, genetic information, disability, status as a protected veteran, or any other protected category under applicable federal, state, and local laws.
Our Vision & Values
Everything we do is about making better health easier 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.
LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow.
INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
SAFETY: We provide a safe environment for our patients and members and the Geisinger family.
Our Benefits
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and prescription coverage.
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