Healthcare Call Center Representative

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

📋 Description

• Manage incoming and/or outgoing calls pertaining to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries.

• Evaluate customer needs and address questions or concerns during the initial contact whenever feasible.

• Investigate inquiries utilizing job aids, knowledge bases, contact center platforms, and various system tools.

• Refer complex or unresolved matters through the established escalation channels.

• Accurately document customer interactions in the required systems with thoroughness.

• Achieve productivity and quality benchmarks, including Average Handle Time, Quality Assurance ratings, and schedule compliance.

• Recognize recurring customer issues, trends, and patterns, and relay them to the relevant team members.

• Adhere to HIPAA, data privacy, security, and confidentiality protocols.

• Collaborate with colleagues, supervisors, and team leaders to resolve inquiries and assist in achieving operational goals.

• Engage in cross-training, knowledge-sharing initiatives, and additional duties as needed.

• Provide support for the Ohio Fiscal Intermediary account in a dynamic contact center setting.

• Availability to work Monday through Friday, from 8:00 a.m. to 4:30 p.m. Eastern Time, or as dictated by business requirements.

⛳️ Requirements

• Minimum of one year of experience in a contact center or customer service role.

• Preferred experience in supporting Medicaid, provider services, healthcare operations, or a similar healthcare setting.

• Familiarity with contact center platforms such as NICE, CXone, Avaya, Verint, or equivalent tools.

• Basic to intermediate skills in Microsoft Office.

• Ability to manage multiple systems simultaneously.

• Excellent verbal communication and active listening abilities.

• Strong attention to detail and organizational capabilities.

• Competence in handling multiple tasks accurately in a fast-paced environment.

• Effective problem-solving and critical thinking skills.

• Ability to evaluate customer needs, investigate information, and identify suitable resolutions.

• Must fulfill remote work technology prerequisites, including a wired Ethernet connection and a minimum internet speed of 150 Mbps.

• Completion of the Assessment is required as part of the interview process.

• Video cameras must be utilized during all interviews and throughout the initial week of orientation.

🏝️ Benefits

• Flexible work options.

• Opportunities for learning and career advancement.

• Generous and flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health insurance benefits.

• Educational assistance programs.

• Leadership and technical development academies.