Healthcare Call Center Representative - Remote

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

About the role

As a Healthcare Call Center Representative - Remote, you will support the Ohio Fiscal Intermediary account by assisting customers with questions related to healthcare services, eligibility, claims, billing, Medicaid, and provider services. You will serve as a trusted point of contact, assessing customer needs, researching inquiries, and delivering accurate and professional support. In this fully remote role, you will work in a fast-paced contact center environment where service quality, productivity, accuracy, and compliance are essential. You will use multiple systems and resources to resolve inquiries while helping improve the health and well-being of the members and communities we serve.

Responsibilities

• Handle inbound and/or outbound calls related to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries
• Assess customer needs and work to resolve questions or concerns during the first interaction whenever possible
• Research inquiries using job aids, knowledge bases, contact center platforms, and other available system tools
• Escalate complex or unresolved issues through established escalation paths
• Document customer interactions completely and accurately in all required systems
• Meet established productivity and quality standards, including Average Handle Time, Quality Assurance scores, and schedule adherence
• Identify recurring customer concerns, trends, and themes and communicate them to the appropriate team members
• Follow HIPAA, data privacy, security, and confidentiality requirements when handling protected or sensitive information
• Collaborate with peers, supervisors, and team leads to resolve customer inquiries and support operational objectives
• Participate in cross-training, knowledge-sharing activities, and other auxiliary functions as necessary

Requirements

• At least one year of contact center or customer service experience; experience supporting Medicaid, provider services, healthcare operations, or a related healthcare environment is preferred
• Experience using contact center platforms such as NICE, CXone, Avaya, Verint, or similar tools, along with basic to intermediate proficiency in Microsoft Office and the ability to navigate multiple systems simultaneously
• Strong verbal communication and active listening skills, with the ability to communicate information clearly and professionally
• Strong attention to detail, organizational skills, and the ability to manage multiple tasks accurately in a fast-paced environment
• Effective problem-solving and critical-thinking skills, with the ability to assess customer needs, research information, and determine the appropriate resolution

Schedule

Work schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern Time, or as required by business needs.

Pay

The pay range for this position is $29,100.00 - $41,600.00 per year. The base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Benefits

• Generous, flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies

Must meet remote-work technology requirements, including a wired Ethernet connection and a minimum internet speed of 150 Mbps. As part of our interview process, all candidates must complete an assessment to evaluate key competencies relevant to the role, including communication skills, multitasking abilities, and problem-solving capabilities. Video cameras must be used during all interviews, as well as during the initial week of orientation.