Customer Service Representative

Wellvana is seeking a professional, compassionate, and detail-oriented Customer Service Representative to provide high-quality support to patients, healthcare providers, practices, and other customers.

The Customer Service Representative serves as an important point of contact for customers and is responsible for answering questions, resolving concerns, providing accurate information, documenting interactions, and connecting customers with the appropriate Wellvana resources or internal teams.

The ideal candidate is patient-focused, empathetic, dependable, and comfortable working in a healthcare environment. This individual should be able to manage multiple requests, communicate clearly with people from diverse backgrounds, and maintain professionalism when handling sensitive or difficult situations.

Essential Responsibilities

• Respond to customer inquiries by telephone, email, text, and other approved communication channels.
• Provide professional, courteous, and timely customer service.
• Listen carefully to understand customer questions, concerns, and needs.
• Provide accurate information about Wellvana programs, services, processes, and administrative procedures within the scope of the position.
• Assist patients and customers in navigating available resources and services.
• Resolve customer issues whenever possible and escalate matters requiring additional assistance.
• Communicate with healthcare providers, medical practices, internal departments, and other authorized stakeholders.
• Document customer interactions, questions, concerns, and resolutions accurately in applicable systems.
• Create and update customer service cases, tickets, or records as required.
• Follow up with customers to ensure questions and concerns have been appropriately addressed.
• Coordinate with internal teams to resolve customer issues.
• Escalate clinical, urgent, sensitive, or complex matters to the appropriate qualified team member.
• Handle customer complaints professionally and follow established escalation procedures.
• Maintain current knowledge of Wellvana services, policies, procedures, and workflows.
• Protect confidential patient, provider, and company information.
• Follow applicable HIPAA, privacy, security, and company requirements.
• Meet established customer service, quality, productivity, and response-time expectations.
• Identify recurring customer concerns and communicate trends to management.
• Participate in training, team meetings, quality-improvement initiatives, and department projects.
• Perform other duties as assigned.

Patient and Customer Support

The Customer Service Representative should provide every customer with a professional and respectful experience.

Responsibilities include:

• Helping customers understand next steps.
• Providing clear explanations of administrative processes.
• Connecting customers with appropriate resources.
• Assisting customers who may be confused or frustrated.
• Maintaining patience and empathy during difficult conversations.
• Taking ownership of customer concerns.
• Following through until the issue has been appropriately resolved or transferred.
• Communicating in a manner that is easy for the customer to understand.

Healthcare Customer Service

Because Wellvana operates in healthcare, the Customer Service Representative may interact with:

• Patients
• Physicians
• Medical practices
• Healthcare providers
• Health systems
• Internal clinical teams
• Care-management teams
• Operations teams
• Business partners

The representative must understand the importance of accuracy, privacy, professionalism, and appropriate escalation when dealing with healthcare-related questions.

The Customer Service Representative should not provide medical advice or make clinical decisions unless separately qualified and specifically authorized to do so.

HIPAA and Confidentiality

This position may involve access to protected health information (PHI) and other confidential information.

The Customer Service Representative must:

• Maintain strict confidentiality of patient and customer information.
• Access information only when necessary to perform assigned responsibilities.
• Follow Wellvana's privacy and information-security procedures.
• Follow applicable HIPAA requirements.
• Verify customer identity according to established procedures before releasing protected information.
• Never disclose confidential information to unauthorized individuals.
• Use approved systems and communication channels.
• Properly document customer interactions.
• Report suspected privacy or security incidents according to company procedures.
• Complete required privacy, HIPAA, and cybersecurity training.

Customer Complaint and Escalation Management

• Listen to customer complaints without becoming defensive.
• Remain calm and professional during difficult interactions.
• Identify the nature of the customer's concern.
• Determine whether the issue can be resolved directly.
• Provide appropriate information or assistance within the scope of the position.
• Escalate issues according to established procedures.
• Document the complaint and actions taken.
• Follow up when required.
• Communicate recurring issues to management for potential process improvement.

Data Entry and Documentation

• Enter customer information accurately into company systems.
• Update records when information changes.
• Maintain accurate notes regarding customer interactions.
• Document the steps taken to resolve customer concerns.
• Review information for completeness and accuracy.
• Maintain organized customer records.
• Follow established documentation standards.

Qualifications

Required Qualifications

• High school diploma or equivalent.
• Previous customer service, healthcare, call center, administrative, or related experience preferred.
• Strong verbal and written communication skills.
• Excellent listening and interpersonal skills.
• Strong problem-solving abilities.
• Ability to remain calm and professional when dealing with upset customers.
• Strong attention to detail.
• Ability to handle confidential information appropriately.
• Basic computer proficiency.
• Ability to learn new software and systems.
• Ability to manage multiple tasks and priorities.
• Reliable attendance and punctuality.
• Ability to work independently and as part of a team.

Preferred Qualifications

• 1–3 years of healthcare customer service experience.
• Previous patient-support or medical-office experience.
• Call center experience.
• Experience working with an electronic health record (EHR).
• Experience with CRM or customer-service platforms.
• Familiarity with HIPAA requirements.
• Experience handling escalated customer concerns.
• Bilingual or multilingual communication skills.

Required Skills

• Customer service
• Active listening
• Verbal communication
• Written communication
• Empathy
• Problem-solving
• Conflict resolution
• De-escalation
• Attention to detail
• Data entry
• Organization
• Time management
• Confidentiality
• Teamwork
• Adaptability

Technology Skills

The Customer Service Representative should be comfortable using:

• Customer Relationship Management (CRM) systems
• Customer-service/ticketing platforms
• Electronic health record systems, where applicable
• Microsoft Office
• Google Workspace
• Email and messaging platforms
• Video-conferencing applications
• Web-based healthcare and administrative systems

Training may be provided for Wellvana-specific systems and processes.

Performance Expectations

Performance may be evaluated using:

• Customer satisfaction
• Quality of customer interactions
• Response time
• Resolution time
• First-contact resolution
• Accuracy of documentation
• Customer-service case volume
• Follow-up completion
• Attendance and punctuality
• Compliance with company policies
• HIPAA and privacy compliance
• Teamwork and communication

Working Environment

This position may be performed in an office, hybrid, or remote environment depending on business requirements.

The Customer Service Representative may spend significant portions of the workday:

• Speaking with customers by telephone.
• Responding to emails and electronic messages.
• Working with customer records.
• Entering information into computer systems.
• Participating in virtual meetings.
• Communicating with healthcare professionals and internal departments.

The position may involve interactions with customers who are frustrated, concerned, confused, or experiencing difficulty navigating healthcare services.

Physical Requirements

• Ability to sit and work at a computer for extended periods.
• Ability to use a keyboard, mouse, telephone, and other standard office equipment.
• Ability to read information displayed on a computer screen.
• Ability to communicate clearly and effectively.
• Reasonable accommodations will be provided to qualified individuals with disabilities in accordance with applicable law.

Compensation and Benefits

Benefits may include healthcare coverage, paid time off, retirement benefits, professional-development opportunities, and other benefits offered by Wellvana, subject to eligibility and applicable company policies.

Equal Employment Opportunity

Wellvana is committed to providing equal employment opportunities to qualified individuals and maintaining a professional, respectful, and inclusive workplace.

Disclaimer

This job description describes the general nature and level of work expected for the Customer Service Representative position. It is not intended to be an exhaustive list of all duties, responsibilities, qualifications, or working conditions. Responsibilities may change based on business needs.