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Customer Service Representative

EmblemHealth Albany Full-Time
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Description of Duties:

  • Receive, answer and/or record telephone/correspondence/e-mail inquiries from subscribers, providers, and other consumers relating to areas of coverage, payment of claims, membership status, medical management intake calls, etc., under the various EmblemHealth medical/surgical, dental, hospital and Medicare plans.
  • Review inquiries, correspondence and email receipts.  Prepare email resolutions, letters (form or narrative letter) and/or claims payment process adjustments.
  • Perform written and verbal duties of the position to meet company goals for production and accuracy.
  • Perform related claims approving and clerical work as assigned.
  • Perform other duties as assigned or required.


  • Must be able to work under pressure, handle stressful situations effectively and deal politely with subscribers and providers on the telephone, in person, and email/correspondence
  • Ability to detect and relate problem service issues to management
  • Ability to speak well on the telephone and maintain a positive telephone personality.
  • Must be able to compose clear concise letters
  • If designated, sort and screen correspondence receipts and resolve via coding of additional payment, possibly including salvage and/or completion by letter
  • Typing and PC skills
  • Ability to adapt to change and address multiple issues simultaneously
  • Good organizational skills
  • Must be available for training
  • Regular attendance is an essential function of the job
  • Bilingual – Spanish required
Education and Experience: 

  • A minimum of two (2) years’ experience in customer service; one year must be in a call center setting.  A college degree is preferred.  Health insurance experience is a plus.
  • Test Subjects:
  • Online: Reading Comprehension
  • Online:  Customer Service
  • Oral Telephone Simulation; Interview

An Equal Employment Opportunity Employer M/F/H/V 

Recruitment may also be conducted externally to obtain the best-qualified candidates

Recommended skills

Customer Service
Clerical Works
Spanish Language


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Customer Service Representative
Estimated Salary: $69K
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Job ID: 190RD


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