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Healthcare Customer Service Representative How to become, career path, income potential

What is a healthcare customer service representative?

Are you looking for a rewarding career in the healthcare industry where you can put your amazing customer service skills to work assisting people? A healthcare customer service representative could be the opportunity that fits your skills.

Healthcare customer service representatives typically work in call centers to help customers understand their healthcare coverage and address any questions or concerns. Healthcare customer service reps need patience and solid verbal communication skills. They should be able to follow scripts to answer questions about authorization for medical treatments, co-payments, benefits, scheduling, follow-ups, and insurance coverage. 

Healthcare customer service reps must have friendly personalities, excellent listening skills, and the need to stay up-to-date on changes in insurance plans. They handle customer issues and complaints, advise them of outstanding co-payments and non-payment, and stay calm when dealing with an angry or frustrated customer. Intermediate computer skills and the ability to work in a high-stress environment are required. Healthcare customer service reps work for hospitals, medical offices, clinics, insurance companies, nursing homes, and other healthcare facilities. In a clinical setting, they may also be responsible for administrative duties. 

A typical day would include answering incoming calls from patients, following up on open items, collecting copays and deductible payments, coordinating information with insurance companies, handling complaints, making appointments, and maintaining the patient information files with billing information and contact information.

Qualifications and eligibility

Healthcare customer service representative should have at least their high school diploma or the equivalent. Some organizations require additional schooling, like an associate’s degree, so that’s never a bad idea. In addition to schooling, applicants should have strong written and verbal communication skills and fantastic customer service. Being able to remain calm while working through stressful situations is important. 

People with any knowledge of medical insurance procedures will have an advantage when applying for the job because you’ll often deal with these policies in this role. Keen attention to detail will also be important because the job duties require checking forms and documents to ensure all proper information is recorded accurately. Good listening skills and phone etiquette should also be part of the skillset.

Work environment

The healthcare customer service representative typically works in an office environment within a clinic or contact center. Representatives must also be able to work with people from all walks of life and be able to handle difficult customer service issues. Many job duties will take place over the phone or on the computer, so representatives should be comfortable sitting for long periods.

Typical work hours

The typical work hours for a customer service representative are from 9 AM to 5 PM if a health care clinic or facility employs them. Customer service representatives who work for insurance companies or hospitals that offer 24-hour customer service may work non-traditional shifts, including nights, weekends, and holidays. The schedule will depend on the role and what environment it’s set up in.


Healthcare customer service representatives have comparable salaries to customer service representatives in other industries, with a slightly higher average salary due to the sensitive nature of their work and additional knowledge gained with experience. It also differs based on geography, experience, type of work environment, and education level. To show an example, here are the top five highest-paying states for customer service representatives shown in annual mean wage:

  • District of Columbia – $48,590
  • Massachusetts – $46,330
  • New York – $45,410
  • California – $44,390
  • Washington – $43,930

Steps to become a healthcare customer service representative

1. Finish your education

Healthcare customer service representative roles require a high school diploma or the equivalent to get on board. Some organizations require additional education, like an associate’s degree or higher. Potential job postings will list applicants’ desired level of education, so you can verify if you qualify before applying. 

2. Boost your skillset with courses in customer service

Help your resume stand out by taking some additional courses in customer service. There are some incredible online resources that you can take at any time and will give you the additional information that will help with your career in healthcare customer service. Here are a few courses we recommend:

  • The Customer Service Fundamentals course from Coursera has great reviews from previous students. It focuses on communication skills and being clear and concise. You’ll also review appropriate empathetic behaviors, problem-solving skills, and the best ways to adhere to the documented processes in the organization. 
  • Another great course option is Customer Service Mastery: Delight Every Customer from Udemy. You’ll be given tons of new ideas to help you delight any customer and stand out from competitors. Not only will you learn some new ideas for yourself, but you’ll be able to bring new ideas to your organization and elevate your entire team. 
  • Udemy also offers a course called Customer Service Success: Take Your Skills to the Next Level. This class focused on three major areas, improving your soft communication skills, customer support, and experience. You’ll learn to build rapport with customers, implement strategies to help you anticipate a customer’s needs, and dive deep into the value of customer service and its impact on your job satisfaction and the company overall. 

3. Acquire a certification

Take courses and get certified with a Healthcare Customer Service Representative Certificate. This will show that you have the knowledge to exceed customer needs in the healthcare field. These courses can all be applied to the medical assistant technical diploma program. 

4. Apply for open jobs

Once you’ve got the education and additional customer service training, you’re ready to apply for jobs. You can visit a healthcare provider’s website and check their job openings. You can also filter on online job search engines for a customer service role in healthcare.

Types of healthcare customer service representatives

Depending on the workplace, there are quite a few duties that healthcare customer service representatives cover. In smaller offices, one rep might be responsible for multiple parts of the process, and in larger organizations, there might be specialized roles. 

Scheduling is a critical task because there would be no patients to take care of without this. This role is done primarily over the phone. You’ll work the calendar to ensure that people have enough time to meet with the doctors and nurses and help with any rescheduling. 

There are healthcare customer service representatives who help with check-in. This role gathers any required information and organizes paperwork. They can help reduce wait times and answer any questions for patients coming in for an appointment. There may also be some payment collections here as well.

Healthcare professionals must have everything they need during appointments to care for patients properly. Reps might assist with stocking the rooms, delivering the paperwork and files to the doctors and nurses, and scheduling any follow-up appointments the patient requires for their care. 

Lastly, insurance is a major area for healthcare customer service representatives. Each insurance company and policy is different, so it’s important to help patients understand what is included in coverage when they have an appointment. Knowing how to invoice and follow up with insurance companies correctly is an additional level of experience in the healthcare field and is important in any environment providing health services. 

Tips for becoming a healthcare customer service representative

Once you have the necessary education, you can apply for any open healthcare customer service representative position. Still, there are a few other tips we have to help you succeed at the role:

  • Take courses about the software programs most frequently used in healthcare settings. This could include CRM software, Electronic Health Records, and scheduling systems. Many software companies have free seminars and classes for the basics on their websites for anyone to check out and familiarize themselves with.
  • Practice your note-taking skills. You’ll have to deal with a lot of information coming at you and having a good strategy for shorthand that you can circle back to later is helpful.
  • Master your phone etiquette. You’ll be on the phone quite a bit in this role, and it’s important to be able to speak clearly and know how to follow cues.
  • Learn as much as you can about the insurance industry and its processes. You will likely have to work with these companies often and the more you know, the better.
  • Familiarize yourself with all the typical office software, like Microsoft and Google, and hardware, like printers. You’ll likely use a mixture of all these tools.
  • See if you can speed up your typing speed with practice and online courses. You’ll be able to get through any data entry tasks quickly, and it can really help make your job easier.

Position trends

According to the customer service technology company, Qualtrics, customer care in the healthcare space is changing. Customers in every sector of the economy are looking for more personal service and 24-hour convenience. That means that many traditional tasks handled by customer service representatives, such as submitting forms and changing appointments, are being automated and controlled by cloud-based patient portals to add convenience to the patient experience. 

However, providing personal service while a patient receives services in a clinic, hospital, or nursing home is now under the purview of a customer service representative. Tasks can include reaching out to patients to see how they’re doing and offering assistance with any potential questions or issues. 

Customer service representatives who work for insurance companies may see an increase in more complex customer care issues that websites and artificial intelligence (AI) cannot adequately handle, rather than more procedural jobs like finding provider referrals and managing patient information.

Career path

Healthcare customer service representatives are usually an entry-level job, so there are plenty of different paths you can take in your career. If healthcare is your passion, great administrative roles go all the way up the chain within hospital and clinic systems. You can also take your customer service experience and explore other industries. Those who are passionate about the customer journey often go into training and development for new recruits or management of contact centers and other large groups of customer service representatives. 

Healthcare customer service representative FAQs