Healthcare Call Center Representative

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

📋 Description

• Manage incoming and outgoing calls regarding healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries.

• Evaluate customer needs and address questions or concerns during the first interaction whenever feasible.

• Investigate inquiries utilizing job aids, knowledge databases, contact center platforms, and other system tools.

• Forward complex or unresolved issues through established escalation channels.

• Accurately and comprehensively document customer interactions in the necessary systems.

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

• Recognize recurring customer issues, trends, and themes, and relay these to the appropriate team members.

• Adhere to HIPAA, data privacy, security, and confidentiality protocols when managing protected or sensitive information.

• Collaborate with colleagues, supervisors, and team leads to address customer inquiries and support operational goals.

• Engage in cross-training, knowledge-sharing initiatives, and other supplementary functions as required.

• Provide support for the Ohio Fiscal Intermediary account on a fully remote basis, Monday through Friday, from 8:00 a.m. to 4:30 p.m. Eastern Time, or as dictated by business needs.

⛳️ Requirements

• A 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 comparable tools.

• Basic to intermediate skills in Microsoft Office.

• Ability to operate multiple systems concurrently.

• Excellent verbal communication and active listening abilities.

• Strong attention to detail and organizational capabilities.

• Capacity to handle multiple tasks accurately in a fast-paced environment.

• Proficient problem-solving and critical-thinking abilities.

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

• Completion of the required assessment is necessary as part of the interview process.

• A video camera is required during all interviews and the initial week of orientation.

🏝️ Benefits

• Flexible work arrangements.

• Opportunities for learning and career advancement.

• Generous and flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.