Healthcare Call Center Representative Remote U.S.

Provide exceptional customer service by telephone to Medicaid providers and members by assisting with coverage, claims, and benefit-related inquiries. Accurately interpret Medicaid benefits and policy provisions, research and resolve disputed claims, and ensure timely follow-up to achieve prompt resolution.

About the role

• Answer inbound calls within 30 seconds
• Use of multiple monitors/screens and systems to service calls
• Be a productive member of the team
• Comply with contract requirements, business unit rules and related legal regulations
• Prior office or clerical experience
• Ability to follow written policies and procedures
• Ability to access and retrieve information using a PC and basic understanding of Microsoft Office products
• Ability to follow procedural guidelines
• Ability to work on assignments with limited instructions from leadership
• Good written and verbal communication skills, including professional telephone skills

This is a fully remote position that requires a dedicated home office or private workspace with a door to ensure a professional, distraction-free work environment. Employees must be available to work Monday through Friday, 8:00 AM to 5:00 PM, with punctuality and reliable attendance being essential. The role requires the ability to maintain focus, meet performance expectations, and adhere to company policies while working remotely. Remote positions require broadband Internet connections with a minimum speed of 24 Mbps download and 8 Mbps upload.

Requirements

• At least one year of call center experience, preferably in healthcare, human services, or Medicaid
• Experience working in a metric-driven environment
• Experience using an auto answer system
• Experience working in the Healthcare Industry / Medicaid specifically
• Experience meeting Service Level Agreements and contractual obligations
• Ability to learn and ask questions to be independent
• Strong customer service, communication, problem-solving, and computer skills

Benefits

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

Pay

The pay range for this position is $35,000.00 - $50,000.00 per year. The base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Schedule

Monday through Friday, 8:00 AM to 5:00 PM.