Remote Customer Experience Specialist – Healthcare Support & Claims Resolution (Work From Home | Oklahoma Residents)

Join careerzynith: Where Compassion Meets Innovation in Healthcare

At careerzynith, we believe that every interaction matters. Our mission is to bring genuine care to every moment of our customers' healthcare journey, delivering human-centered service in an increasingly digital world. As a leading force in the healthcare services industry, careerzynith is anchored by a brand philosophy that places heart at the center of everything we do. We are committed to making healthcare more personal, more convenient, and more affordable for the millions of members and providers we serve.

When you join careerzynith, you become part of a purpose-driven organization where your role directly contributes to transforming the customer experience in healthcare. Our "Heart At Work" culture empowers every team member to innovate, collaborate, and deliver solutions that truly make a difference. If you are passionate about helping others, thrive in a fast-paced environment, and want to build a meaningful career from the comfort of your home in Oklahoma, this opportunity is designed for you.

Position Overview

careerzynith is seeking a dedicated, empathetic, and detail-oriented Remote Customer Experience Specialist to join our dynamic Claims Inquiry and Claims Research team. In this fully remote role, you will serve as the first point of contact for members, healthcare providers, and plan sponsors, resolving complex inquiries through phone, email, and written correspondence. This is not a typical customer service position — you will be at the intersection of healthcare administration and member support, using critical thinking and claims research expertise to deliver accurate, timely, and compassionate service.

This position is based remotely within the State of Oklahoma and offers the flexibility of working from home while being part of a connected, supportive team. After completing a comprehensive four-week virtual training program, you will transition to a stable Monday through Friday schedule with shift flexibility between 7:00 AM and 7:00 PM CST.

Key Responsibilities

• Customer Engagement: Maintain a positive, empathetic, and professional demeanor when interacting with members, providers, and plan sponsors across multiple communication channels, including phone, email, and written correspondence.
• Inquiry Resolution: Respond promptly and accurately to high-volume inbound calls and written inquiries, addressing questions related to claims, payments, benefits, and plan coverage.
• Claims Research and Analysis: Conduct extensive claims research across multiple platforms and internal systems to assist providers with payment questions, eligibility verification, and coverage determinations.
• Issue Triage and Escalation: Identify complex issues that require escalation and route them to the appropriate internal teams, ensuring timely resolution and follow-through.
• Order and Request Processing: Process various forms, applications, requests, claim referrals, new claim handoffs, nurse reviews, complaints, grievances, and appeals using our target systems.
• Product and Plan Knowledge: Develop deep expertise in careerzynith products, benefit plans, and self-service tools so you can confidently answer questions and proactively share related information that customers may not even think to ask.
• Documentation and Recordkeeping: Maintain accurate records of all customer interactions, transactions, comments, and complaints in accordance with company policies and regulatory requirements.
• Financial Decision Making: Use the established customer service threshold framework to make appropriate financial decisions that resolve member issues while protecting organizational interests.
• Provider Education and Support: Educate providers on self-service options, assist with credentialing, re-credentialing, and contracting questions, and serve as a knowledgeable resource for healthcare professionals.
• Cross-Functional Collaboration: Communicate and coordinate with colleagues across departments to ensure seamless customer experiences and efficient issue resolution.
• Process Improvement: Provide constructive feedback on the efficiency of the customer service process, contributing to continuous improvement initiatives and operational excellence.
• Team Leadership: Manage and mentor a team of junior customer service representatives, providing guidance, support, and performance feedback to help them succeed.
• Audit Support: Assist in compiling claim data for customer audits, ensuring accuracy and completeness of all documentation.
• Rights and Responsibilities Education: Clearly explain member rights and responsibilities in accordance with contract terms, ensuring transparency and trust in every interaction.

Essential Qualifications

To succeed in this role, candidates must meet the following requirements:

• Residency Requirement: Must be a full-time resident of the State of Oklahoma and remain in the state for the duration of employment.
• Technical Proficiency: Demonstrated familiarity with Microsoft Office products, including Word, Excel, and Outlook, with the ability to learn new systems quickly.
• Call Center Experience: Previous experience working in a highly transactional, high-volume call center environment is required.
• Customer Service Excellence: A proven track record of delivering exceptional customer service, with strong critical thinking and problem-solving skills.
• Internet Connectivity: Access to high-speed internet with a minimum download speed of 25 Mbps and a consistent, reliable connection.
• Wired Connection Requirement: Your home office must be set up with a direct ethernet connection to your router. Wi-Fi connections are not permitted. careerzynith provides a 6.5-foot ethernet cord; if your workspace requires a longer cable, you will need to supply your own.
• Education: High School diploma or GED equivalent is required.

Preferred Qualifications and Skills

While not required, the following qualifications will help you stand out as a candidate:

• Prior experience in healthcare customer service, claims processing, or insurance industry support.
• Familiarity with medical terminology, healthcare billing codes, or claims adjudication processes.
• Experience mentoring or leading team members in a customer service setting.
• Strong written communication skills with the ability to craft clear, professional correspondence.
• Comfort working with multiple software platforms and database systems simultaneously.
• Demonstrated ability to remain calm and solution-focused when customers are frustrated or distressed.
• Bilingual capabilities are a plus but not required.

Training and Schedule Details

Successful candidates will participate in a comprehensive four-week virtual training program conducted between the hours of 8:00 AM and 5:00 PM CST. This training is mandatory and provides the foundational knowledge and skills needed to excel in the role. Training is delivered remotely, allowing you to learn from the comfort of your home office while becoming fully integrated into the careerzynith culture and operational standards.

Upon completion of training, you will transition to a permanent Monday through Friday schedule. Shift times can begin as early as 7:00 AM CST and end as late as 7:00 PM CST, providing some flexibility to accommodate your preferred work style while meeting business needs.

Work Environment and Company Culture at careerzynith

careerzynith is more than just a workplace — it is a community united by a shared commitment to improving lives. Our "Heart At Work Behaviors" framework guides how we interact with one another and with the customers we serve. We believe that how we deliver our services is just as important as what we deliver, and this principle shapes every aspect of our culture.

As a remote team member, you will enjoy the best of both worlds: the flexibility and convenience of working from home, combined with the support, connection, and collaboration of a tight-knit team. careerzynith invests heavily in virtual engagement, regular check-ins, and professional development opportunities to ensure that remote employees feel valued, included, and empowered to do their best work. We celebrate diversity, encourage innovation, and foster an environment where every voice is heard.

Career Growth and Development Opportunities

At careerzynith, your career trajectory is not limited to a single role. We are deeply committed to the professional growth of our team members and offer numerous pathways for advancement. Whether you aspire to deepen your expertise in claims resolution, move into team leadership, or explore other areas of healthcare operations, careerzynith provides the resources, mentorship, and training programs to help you achieve your goals.

Team members have access to ongoing learning opportunities, cross-functional projects, and leadership development programs designed to accelerate professional growth. Many of our senior leaders started in entry-level customer service roles, and we take pride in promoting from within whenever possible.

Compensation, Perks, and Benefits

careerzynith offers a comprehensive compensation and benefits package designed to support the well-being and financial security of our team members. While specific compensation will be discussed during the interview process, our typical benefits include:

• Competitive hourly wage with potential for performance-based incentives.
• Comprehensive medical, dental, and vision insurance options.
• Retirement savings plans with company matching contributions.
• Paid time off, including vacation days, sick leave, and holidays.
• Employee assistance programs supporting mental health and wellness.
• Tuition reimbursement and continuing education support.
• Discounts on careerzynith products and services.
• Home office setup support and equipment provided for remote roles.

How to Apply

If you are a resident of Oklahoma, possess a passion for helping others, and are ready to launch or grow your career in healthcare customer service, we encourage you to apply today. This is your opportunity to join a purpose-driven organization that values your contributions, invests in your development, and empowers you to make a meaningful impact every single day.

At careerzynith, we are transforming healthcare one conversation at a time. Bring your skills, your heart, and your commitment to excellence — and become part of a team that is changing lives for the better. We look forward to welcoming you to the careerzynith family.