Customer Care Representative II at SKYGEN USA

SKYGEN is seeking a dedicated and customer-focused Customer Care Representative II to join its fully remote team.

This position is ideal for individuals with strong communication, problem-solving, and customer service skills who enjoy helping people resolve concerns and navigate healthcare benefits.

The successful candidate will assist dental and vision insurance members and providers with inquiries regarding eligibility, coverage, claims, authorizations, and other essential services.

This opportunity offers a supportive work environment, professional development, and the flexibility of working remotely from anywhere within the United States.

Work Schedule and Benefits

Work Arrangement: 100% remote within the United States.

Training Period: First 12 weeks, Monday through Friday, 8:00 AM – 4:30 PM CST.

Regular Schedule: Multiple shifts available, with start times ranging from 6:00 AM to 10:30 AM CST, Monday through Friday.

Operating Hours: 6:00 AM – 10:00 PM CST, Monday through Friday. Shifts may change based on business requirements.

Additional Compensation: $2.00 per hour shift differential on Mondays and Tuesdays.

Additional Hours: Occasional evening, weekend, and holiday shifts may be required during the Medicare Annual Open Enrollment period, October 1 through March 31.

Career Development: Opportunities for professional growth in a collaborative and rewarding environment.

Key Responsibilities

As a Customer Care Representative II, you will be responsible for delivering exceptional support while ensuring customers and healthcare providers receive accurate, timely assistance.

Your primary responsibilities will include:

• Respond to incoming calls from dental and vision insurance members and providers, addressing questions about eligibility, benefits, claims, authorizations, and provider availability.
• Assist customers in locating healthcare providers within their geographical area.
• Review claim adjustments and resubmission procedures to identify appropriate solutions to provider inquiries.
• Collaborate with the Provider Relations team to resolve complex claim concerns, reimbursement discrepancies, and conflicting information.
• Support enrollment processes, including primary care provider assignments and updates to third-party insurance records.
• Work closely with client Member Services teams to resolve eligibility issues, appeals, and grievances.
• Provide healthcare providers with updates regarding credentialing applications.
• Educate providers on available online self-service tools and encourage the effective use of the provider portal.
• Handle customer calls professionally while following company policies, quality standards, and client requirements.
• Maintain accurate records of customer interactions, inquiries, and resolutions in internal systems.
• Demonstrate patience, empathy, and professionalism when handling sensitive or challenging situations.
• Apply effective conflict-resolution techniques to ensure customers feel understood, respected, and supported.
• Identify complex concerns requiring management intervention and escalate them appropriately.

Additional Duties

• Recommend improvements to customer service systems, procedures, and operational workflows.
• Notify the Provider Relations team of provider directory changes, manual discrepancies, and other relevant concerns.
• Participate in departmental initiatives and projects when required.
• Support continuous improvements that enhance customer satisfaction and service efficiency.

Minimum Qualifications

Education

• High school diploma or equivalent qualification.

Experience

• At least one year of relevant customer service experience in healthcare, banking, retail, call centers, or a similar customer-facing industry.

Required Skills

• Proficiency in Microsoft Office applications, including Word, Excel, and Outlook.
• Excellent verbal communication and active listening skills.
• Strong customer service abilities with a genuine commitment to empathy and professionalism.
• Accurate typing, data entry, and documentation skills.
• Ability to navigate multiple computer systems and manage several tasks simultaneously.
• Excellent organizational skills and attention to detail.
• Strong analytical and critical-thinking abilities to assess customer concerns and identify practical solutions.
• Ability to remain calm and professional when handling difficult customer interactions.
• Willingness to work occasional overtime when business demands require additional support.

Preferred Qualifications

Candidates will have an advantage if they possess:

• At least one year of customer service experience in the dental, vision, or medical insurance industry.
• Previous experience working in a remote or virtual customer service environment.
• Familiarity with healthcare insurance terminology, including dental, vision, and medical benefits.
• Experience handling insurance claims, provider inquiries, or healthcare member support.

Salary and Compensation

Hourly Pay: $16.42 – $24.63

Estimated Annual Salary: $34,154 – $51,230, based on a standard 40-hour workweek and 52 weeks annually, excluding overtime and additional shift compensation.

Eligible employees may also receive an additional $2.00 per hour differential on Mondays and Tuesdays.

About SKYGEN

SKYGEN is a healthcare technology and benefits administration company specializing in dental and vision insurance solutions.

The organization partners with specialty benefits payers and government agencies to simplify healthcare administration and improve service delivery.

Through innovative technology, efficient processes, and customer-focused solutions, SKYGEN helps healthcare organizations enhance operational performance and provide better experiences for members and providers.

How to Apply

Interested applicants who meet the requirements are encouraged to apply through SKYGEN’s official recruitment platform.