Temporary Customer Care Rep

Company Overview

Detego Health's mission is to connect real-life needs with innovative product design, delivering affordable, approachable health care benefits that feel personal, while deeply understanding our members and partners to improve lives and redefine access to health care.

We're looking for passionate people who want to make a difference and help us redefine access to health care for individuals and small businesses by delivering certainty, connection and significance where others won’t.

Ready to build something great together? Join a team that values growth, collaboration and the unique perspective you bring.

Position Summary

The Temporary Customer Service Member Support Rep serves as the frontline member advocate and primary point of contact for Detego Health members. This role assists members with routine questions regarding eligibility, benefits, claims, billing, provider networks, pharmacy benefits, and available member resources while delivering a professional, empathetic, and member-focused experience.

Customer Service Member Support Rep team members work within established procedures, workflows, and service standards to resolve routine inquiries, educate members regarding their coverage, accurately document interactions, and escalate complex or unresolved concerns as appropriate.

This is a non-clinical customer service position focused exclusively on health insurance navigation and member advocacy. Customer Service Member Support Reps do not provide medical advice, diagnose medical conditions, recommend treatments, interpret clinical information, or deliver healthcare services.

This role will run through February 2027 with the potential to extent or covert to full time.

Key Responsibilities

• Serve as the first point of contact for member inquiries via telephone, email, and other approved communication channels.

• Deliver a positive, professional, empathetic, and member-focused experience during every interaction.

• Verify member identity and protect confidential information in accordance with HIPAA and company privacy requirements.

• Educate members regarding eligibility, enrollment, benefits, claims, billing, provider networks, pharmacy benefits, prior authorizations, reimbursement programs, and available member resources.

• Research and resolve routine member inquiries using approved systems, knowledge bases, and internal resources.

• Accurately document all member interactions in Salesforce CRM and other required systems.

• Conduct outbound calls for follow-up, education, issue resolution, and member engagement as assigned.

• Escalate complex, sensitive, or unresolved issues to appropriate internal resources or higher-level Care Guides.

• Meet departmental standards for quality, productivity, average handle time, first call resolution, documentation accuracy, schedule adherence, attendance, and compliance.

• Participate in training, coaching, team meetings, and continuous improvement activities.

• Perform other related duties as assigned.

Qualifications

• Excellent customer service, communication, active listening, conflict resolution, and de-escalation skills.
• Ability to build rapport and provide an exceptional member experience.
• Ability to work in a fast-paced, metrics-driven call center environment.
• Ability to handle consecutive inbound and outbound calls while balancing efficiency, quality, and accuracy.
• Strong computer navigation skills and ability to work across multiple applications and monitors simultaneously.
• Strong documentation, data entry, and CRM/case management system skills.
• Ability to learn new software systems and internal processes quickly.
• Understanding of eligibility, enrollment, benefits, claims, provider networks, pharmacy benefits, deductibles, copayments, coinsurance, out-of-pocket maximums, prior authorization, and Explanation of Benefits.
• Ability to educate members about benefits without providing medical advice.
• Strong analytical and problem-solving skills.
• Sound judgment when handling confidential, sensitive, or escalated member information.

Equal Opportunity Statement

Detego Health is an Equal Opportunity Employer. We are committed to an inclusive workplace.

Benefits & Compensation
Pay: 21.00 – 24.00

Work Location: In Person

Benefits:

401(k) matchingnce

• Employee assistance program
• Health insurance
• Paid time off
• Vision insurance