Corewell Health · 3 hours ago
Senior Customer Service Rep
St Joseph, MI
Full-time
Hybrid
Senior Level
5+ years expCorewell Health is a nationally recognized health system committed to delivering personalized health care to patients and communities. The Senior Customer Service Rep will assist members, employer groups, and providers with health plan benefits, resolving complex problems, and ensuring exceptional customer experiences through various communication channels.
Health CareHospitalMedical
Responsibilities
Demonstrates high competency in analyzing, evaluating, and responding to complex service inquires from members, providers, employer groups, colleagues, agents, Elite agents, and different customer types across multiple Priority Health products within departmental guidelines. Regularly serve as subject matter expert ensuring professional and pleasant interactions at all times
Partnering with internal and external resources, promptly provides customers with information and education concerning benefit clarification, eligibility requirements, verification, authorization, billing and claim status. Identifies potential trends or issues that impact health plan members and works with coworkers and leadership resources to suggest process improvements
Promptly identifies and resolves or escalates customer concerns or complaints to achieve positive outcomes. Places outbound welcome calls to members to educate them on their benefits as needed. Assists walk-in members and agents if assigned by leadership
Adheres to established procedure and quality guidelines in support of Priority Health service promise, key drivers, performance indicators, as well as Corporate values and codes of excellence. Serves as a role model of exceptional customer service and assists with providing Best Practice benchmarks in procedures
Assists customers with administrative issues, such as submitting enrollment record changes, providing letter explaining coverage or benefits, and obtaining and relaying certain member information to other departments as needed
Facilitates claims resolution through follow-up on member calls and correspondence received to appropriate departments
Effectively tracks and/or documents all service interactions with customers within appropriate systems within guidelines. Also provides direct subject matter expertise to peers and the leadership team through participation in Resource Line, mentoring of newly skilled employees, and committees as assigned
Develops and maintains behaviors of productivity, availability to customers, and adherence to work schedule
Qualification
Required
High School Diploma or equivalent
5 years of relevant experience in customer-facing service on phone or face-to-face, focus on positive customer outcomes; customer service and/or managed health care
Preferred
Associate's Degree
Benefits
Comprehensive benefits package to meet your financial, health, and work/life balance goals.
On-demand pay program powered by Payactiv
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, travel, and more!
Optional identity theft protection, home and auto insurance, and pet insurance
Traditional and Roth retirement options with service contribution and match savings
Company
Corewell Health
Corewell Health is a not-for-profit health system that provides health care and coverage with an exceptional team
10001+ employees
H1B Sponsorship
Corewell Health has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (49)
2024 (11)
Funding
Current Stage
Late StageLeadership Team
Lynn Patterson
Sr. Executive Specialist To Chief Executive Officer
Karen Smith
Advisor to the Chief Financial Officer
Recent News
2026-01-12
2026-01-06
Company data provided by crunchbase