Customer Service Representative - Healthcare

About the Company

Wellfleet, part of a Berkshire Hathaway company, provides customer-focused accident and health insurance with an emphasis on dependable service and strong ethics. The organization helps protect individuals from risk at different stages of life, including school, college, and work.

Established in 1993 as Consolidated Health Plans (CHP), Wellfleet is headquartered in Springfield, Massachusetts and is recognized as a major provider of health and accident insurance products for the higher education market.

Role Overview

Wellfleet is seeking an experienced healthcare customer service professional to support the Student Health team. This position requires the ability to work from 8:30 am to 5:00 pm PST (11:30 am to 8:00 pm EST).

The role focuses on delivering high-quality customer service for health insurance products while following company standards, internal procedures, and relevant state and federal regulations. The position also requires handling customer questions, maintaining compliance, and supporting operational processes tied to service delivery.

Key Duties

• Complete training successfully and begin handling calls for customer service products.
• Use customer service knowledge and training effectively while managing calls from members and providers.
• Handle calls with active listening, clear communication, professionalism, and efficient call control.
• Respond to incoming calls promptly, identify needs through clarifying questions, demonstrate empathy, provide accurate information, and either resolve issues or escalate them when necessary.
• Build working knowledge of health insurance basics and the products supported by Wellfleet.
• Operate the department’s systems efficiently and accurately.
• Consistently meet quality benchmarks and schedule adherence targets set by customer service leadership.
• Read and interpret training documents, correspondence, brochures, and similar materials.
• Balance multiple tasks during the day to meet expectations and team objectives.
• Maintain a positive, professional attitude at all times.
• Work within deadlines and turnaround-time expectations.
• Stay engaged, motivated, and committed to both individual and team success.
• Make sure all required equipment is working properly and report system or equipment issues quickly to a supervisor or designated proxy, including submitting IT tickets when needed.
• Carry out any other responsibilities assigned by management.

Candidate Profile

The ideal applicant should have at least one year of customer service experience in a health insurance environment or medical billing office, with familiarity in medical terminology, health plan documentation, or benefit plan design.

Strong call center experience is required, along with solid written, verbal, and interpersonal communication skills. The role also calls for professional phone etiquette, careful attention to detail, good time management, sound judgment, and effective problem-solving abilities.

Candidates should be service-oriented, empathetic, and willing to help resolve questions at the first point of contact. A strong sense of accountability, teamwork, and reliability is important, along with a commitment to attendance, punctuality, and quality.

Applicants must be comfortable using Microsoft Office, Windows-based PC applications, and other evolving computer systems. The role requires the ability to multitask without compromising service quality, attend training and team meetings with camera participation, adapt to a changing work environment, and work flexible hours or overtime when needed.

Remote employees must maintain a separate, dedicated workspace that protects privacy and avoids distractions.

Training and Work Setup

New hires will begin with an on-site orientation at the Springfield, Massachusetts office during the first week. This orientation introduces the team, workplace culture, policies, and operating procedures, and includes hands-on role-specific training.

Compensation and Benefits

The base hourly pay for this role is between $22.00 and $25.00. Compensation is influenced by factors such as qualifications, skills, and competencies.

Wellfleet provides a benefits package that may include medical, vision, and dental insurance options, life and accident coverage, 401(k), and short-term and long-term disability insurance.

Additional employee benefits mentioned include life and health coverage, a retirement plan, flexible/dependent care spending accounts, tuition reimbursement, and business casual dress.

Company Culture

Wellfleet promotes a growth-oriented environment where high-performing employees are encouraged to contribute to the company mission and improve service delivery. The team is focused on exceeding customer expectations and continuously improving value for members and clients.

Employment Notes

This is a remote full-time position in the United States. The employer notes that all team members are employees of MedPro Group Inc. and that Wellfleet is part of the MedPro Group family. The company is an Equal Opportunity Employer.