Customer Service Representative- Health Care Concierge - Hybrid

Make a difference every day by supporting members during some of their most important moments. Join our award-winning Member Services Team as a Health Care Concierge, the voice of UPMC Health Plan. In this role, you'll help members understand their health coverage, solve problems, and navigate their benefits with confidence. This is a full time, hybrid position. Must be located in or around Pittsburgh, PA to be considered. 

This is a high-volume, 100% phone-based role where you'll spend your entire scheduled shift assisting members back to-back in a highly technical, fast-paced call center environment providing clear, compassionate, and knowledgeable support. 

Responsibilities: 

- Respond to high volumes of incoming calls, emails, and chats from members and providers 

- Help members understand benefits, claims, prior authorizations, billing, and coverage details 

- Resolve issues accurately and efficiently to avoid repeat calls 

- Document all interactions while listening and responding in real time 

- Navigate multiple computer systems at once 

- Make outbound follow-up calls when needed 

- Stay informed on policies, products, and system updates 

- Deliver professional, empathetic service—every call, every time 

What Makes This Role Challenging and Rewarding 

As an HCCA, you'll become an expert across many areas of health insurance. No two calls are the same, you may shift from claims questions to provider searches to complex benefits conversations within minutes. Success requires staying focused, thinking critically, and handling constant change. 

You'll need strong: 

- Multitasking skills — typing and documenting while listening, talking, and problem-solving 

- Computer proficiency — navigating multiple screens, tools, and systems accurately and quickly 

- Adaptability — switching between a wide range of call types throughout the day 

- Composure under pressure — managing difficult conversations with empathy and professionalism 

- Communication skills — breaking down complex insurance terms into easy, supportive explanations 

Please note: You will spend the entire day working on a computer while managing back-to-back calls. Accuracy, focus, and attention to detail are essential in this fast-paced environment. 

Work Environment Expectations 

- To deliver the level of service our members deserve; this role requires continuous focus and minimal distractions. 

- Because this is a fast-paced, high-volume phone position: 

- Interruptions, competing responsibilities, or background noise can't interfere with call flow 

- A quiet, private, interruption-free workspace is required for success 

What You Need to Know 

- Pay: Set rate of $20.70/hour 

- Hours of Operation: 7 days a week, 8:00 AM - 8:00 PM 

- Location: Must live within 90 miles of Pittsburgh or Erie 

- Work Environment: Hybrid Role: Remote day-to-day work with occasional on-site needs for technology or operational reasons. 

- Schedule: You will be assigned variable 8-hour shifts, which includes daylight, evening, and rotating weekends

- Weekend schedules typically include 1- 2 weekends per month, scheduled as either a Saturday or a Sunday 

- Mandatory Overtime:- 30–90 minutes of mandatory overtime per day, scheduled weekly 

- Holiday Coverage:- Availability to work certain holidays is required, including New Year's Day and Martin Luther King Jr. Day 

- Training: Paid, comprehensive on-the-job training 

- Growth: Full benefits a clear path for development and advancement 

Internet Requirements for Remote Work 

- Wired Ethernet connection required 

- Minimum speeds: 20 Mbps download / 5 Mbps upload 

- Satellite, hotspot, or DSL not permitted 

- Speed test required after offer acceptance

 If you're looking for a role where you can make a real impact—and you thrive in a dynamic, fast-paced environment—we'd love to meet you. Apply today and help us make a difference in the lives of our members.

• High school diploma or equivalent required. 
• College degree preferred.
• Minimum of 2 years of customer service and/or call center experience.
• Proficient in typing required.
• Proficient writing skills required.
• Ability to make independent decisions required.
• Knowledge of Microsoft Office and Excel spreadsheet program preferred.
• Complex analytical skills necessary to evaluate customer inquiries.
• Demonstrates good organizational skills.
• A desire to help others and portray empathy in all situations.
• Ability to learn complex health plan information.
• Demonstrate flexibility and motivation to learn & grow in the position.
• Flexibility in work schedule.
  
  Licensure, Certifications, and Clearances:

- ACT 34

UPMC is an Equal Opportunity Employer/Disability/Veteran