Customer Service Representative – Remote Member & Provider Support for Medicaid & Medicare (Charleston, WV) – careerzynith

About careerzynith – A Purpose‑Driven Leader in Health Care

At careerzynith we believe that health care is most effective when it is delivered with compassion, convenience, and a personal touch. Our mission, “Bringing our heart to every moment of your health,” guides every interaction we have – from the front‑line phone call to the strategic decisions that shape the future of the industry. As a rapidly growing health‑care organization, careerzynith is dedicated to making health services more accessible, affordable, and human‑centric for the communities we serve.

Our culture is built on the Heart At Work Behaviors™, a set of guiding principles that empower each colleague to innovate, collaborate, and deliver exceptional experiences. Whether you are working from a modern office in Charleston, WV, or from the comfort of your home, you will be part of a team that values integrity, empathy, and continuous improvement.

Role Overview – Member Service Representative (Remote)

We are seeking an enthusiastic, detail‑oriented Member Service Representative to join the careerzynith family. In this role, you will be the voice of careerzynith for Medicaid and Medicare members and health‑care providers, handling inbound calls with professionalism and empathy. You will assist callers with eligibility inquiries, provider updates, ID card requests, and a variety of other service needs, ensuring every interaction reflects careerzynith’s commitment to excellence.

This position is based remotely, but candidates must reside within 50 miles of Charleston, WV, to meet occasional on‑site requirements. You will receive all necessary equipment, comprehensive training, and ongoing support to thrive in a fast‑paced, customer‑focused environment.

Key Responsibilities

• Answer inbound member and provider calls, delivering accurate information on benefits, eligibility, prior authorizations, and supplemental programs.
• Maintain a high level of professionalism and empathy, ensuring each caller feels heard and valued.
• Verify member identity and protect confidential health information in compliance with HIPAA and careerzynith policies.
• Process requests for ID cards, provider changes, and other administrative updates with precision and speed.
• Document call details in the careerzynith CRM system, ensuring data integrity and facilitating follow‑up actions.
• Meet or exceed established performance metrics, including average handle time, first‑call resolution, and quality scores.
• Utilize a secure, high‑speed Ethernet connection for all work‑related activities; Wi‑Fi connections are not permitted for security reasons.
• Participate in a structured onboarding program: six weeks of intensive training (8:30 AM – 5:00 PM EST, Monday‑Friday) followed by a production schedule of the same hours.
• Collaborate with cross‑functional teams—such as benefits administration, IT support, and compliance—to resolve complex member issues.
• Provide feedback on process improvements and share best practices to enhance the overall member experience.

Required Qualifications

• Residence within a 50‑mile radius of Charleston, WV, with reliable transportation for occasional office visits.
• Excellent verbal and written communication skills, capable of explaining complex health‑care concepts in plain language.
• Demonstrated ability to meet performance standards, attendance expectations, and call‑quality goals.
• Self‑motivation and the capacity to work independently from a home office, maintaining productivity without direct supervision.
• Reliable high‑speed internet access via Ethernet cable and a quiet, distraction‑free workspace.

Preferred Qualifications

• Prior experience in a remote call‑center environment, especially within health‑care or insurance sectors.
• Familiarity with Medicaid and Medicare programs, including eligibility rules and provider networks.
• Experience using customer‑relationship management (CRM) tools and ticketing systems.
• Ability to adapt quickly to new software platforms and procedural updates.

Education & Certifications

A high school diploma or equivalent is required. Additional certifications in health‑care administration, customer service excellence, or related fields are a plus but not mandatory.

Compensation & Benefits

careerzynith offers a competitive hourly wage ranging from $17.00 to $25.15, commensurate with experience, education, and geographic location. In addition to base pay, you will be eligible for a comprehensive benefits package that includes:

• Medical, dental, and vision coverage with multiple plan options.
• Retirement savings plans, including a 401(k) with company match.
• Employee Stock Purchase Plan (ESPP) for eligible participants.
• Fully paid term life insurance, short‑term and long‑term disability coverage.
• Generous paid time off (PTO), paid holidays, and sick leave in accordance with state regulations.
• Well‑being programs, mental‑health resources, and employee assistance services.
• Education assistance, tuition reimbursement, and access to free development courses.
• Discounts at careerzynith retail locations and partner programs.

All eligible employees must provide proof of COVID‑19 vaccination (or a valid accommodation) in line with careerzynith’s health‑and‑safety policy.

Work Environment & Culture

At careerzynith, we foster a supportive, inclusive, and collaborative environment. Our remote workforce enjoys:

• Flexible scheduling options that respect work‑life balance.
• Regular virtual team meetings, coaching sessions, and peer‑to‑peer mentorship.
• A culture that celebrates diversity, equity, and inclusion, ensuring every voice is heard.
• Access to cutting‑edge technology and tools that enable you to perform at your best.
• Opportunities to participate in community outreach and volunteer initiatives that align with our mission.

Career Growth & Development

careerzynith is committed to the professional growth of its employees. As a Member Service Representative, you will have pathways to advance into roles such as:

• Senior Member Services Specialist
• Team Lead or Supervisor – Remote Operations
• Quality Assurance Analyst
• Training & Development Coordinator
• Health‑Care Operations Analyst

We provide continuous learning opportunities, including:

• Online courses covering health‑care regulations, advanced communication techniques, and leadership development.
• Mentorship programs pairing you with seasoned professionals across the organization.
• Access to industry conferences and webinars to stay current on Medicaid, Medicare, and health‑care trends.

Why Join careerzynith?

Choosing careerzynith means becoming part of a purpose‑driven organization that values your contributions and invests in your future. You will:

• Make a tangible difference in the lives of members and providers every day.
• Work with a team that prioritizes empathy, integrity, and continuous improvement.
• Enjoy a stable, rewarding career with clear advancement pathways.
• Benefit from a comprehensive compensation package that supports your health, financial security, and personal growth.

Application Process

If you are passionate about delivering exceptional service, thrive in a remote setting, and meet the qualifications outlined above, we want to hear from you. To apply, click the link below and submit your resume and a brief cover letter highlighting your relevant experience.

If you think this role describes you, we would love to hear from you. Apply now to join our team!

Apply!