Healthcare Call Center Representative

This is a fully remote position, open to applicants in Maryland.

📋 Description

• Deliver outstanding customer service via telephone to Medicaid providers and members.

• Assist with inquiries related to coverage, claims, and benefits.

• Precisely interpret Medicaid benefits and policy details.

• Investigate and resolve disputed claims effectively.

• Ensure timely follow-up to facilitate prompt resolution.

• Respond to inbound calls within 30 seconds.

• Utilize multiple monitors/screens and systems to manage calls.

• Contribute positively as a team member.

• Adhere to contract stipulations, business unit regulations, and relevant legal standards.

• Maintain effective time management, attendance, and punctuality.

⛳️ Requirements

• Minimum of one year of call center experience, ideally in healthcare, human services, or Medicaid.

• Experience in a metrics-driven environment.

• Familiarity with using an auto-answer system.

• Background in the Healthcare Industry, specifically Medicaid.

• Proven track record of meeting Service Level Agreements and contractual commitments.

• Prior experience in an office or clerical setting.

• Capability to learn independently and ask questions as needed.

• Ability to adhere to written policies, procedures, and guidelines.

• Proficiency in accessing and retrieving information using a PC.

• Basic knowledge of Microsoft Office applications.

• Ability to work on tasks with minimal guidance from leadership.

• Strong written and verbal communication skills, including professional telephone etiquette.

• Dedicated home office or private workspace with a door.

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

• Consistent punctuality and reliable attendance.

🏝️ Benefits

• Flexible work arrangements.

• Opportunities for learning and career advancement.

• Generous and flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health benefits.

• Educational assistance programs.

• Leadership and technical development academies.