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.

Responsibilities

• Answer inbound calls within 30 seconds
• Use 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
• Maintain time management, attendance, and punctuality

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
• 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
• Fully remote position requiring a dedicated home office or private workspace with a door to ensure a professional, distraction-free work environment
• Must be available to work Monday through Friday, 8:00 AM to 5:00 PM with punctuality and reliable attendance

Skills

• Strong customer service
• Communication
• Problem-solving
• Computer skills
• Ability to learn and ask questions to be independent

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.