Call Center Representative - Remote NV

Gainwell Technologies LLC

10d•Remote

About The Position

As a Call Center Representative - Remote NV at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.Your role in our mission Support Gainwell’s mission to improve health and human services outcomes by serving in the Nevada Medicaid Medical Management Prior Authorization (PA) Call Center. Respond to client inquiries related to prior authorizations, level of care determinations, PASRR screenings, and personal care service intakes, escalating complex issues as appropriate. Resolve client issues through effective problem-solving, accurate documentation, and follow-up to ensure timely resolution. Meet service level agreements (SLAs) and production targets while completing call and non-call tasks, including PASRR portal support, email inquiries, and limited provider appeals. Collaborate with team members and management, assist with cross-training, and recommend workflow improvements to increase efficiency and effectiveness.

Requirements

2 or more years of customer service experience in any industry
Knowledge of basic help desk software, computer software and Microsoft Office applications
Strong problem-solving skills to bring inquiries to effective resolution
Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally
Ability to understand your role on a team and identify the correct stakeholders to consult to resolve client inquiries

Responsibilities

Support Gainwell’s mission to improve health and human services outcomes by serving in the Nevada Medicaid Medical Management Prior Authorization (PA) Call Center.
Respond to client inquiries related to prior authorizations, level of care determinations, PASRR screenings, and personal care service intakes, escalating complex issues as appropriate.
Resolve client issues through effective problem-solving, accurate documentation, and follow-up to ensure timely resolution.
Meet service level agreements (SLAs) and production targets while completing call and non-call tasks, including PASRR portal support, email inquiries, and limited provider appeals.
Collaborate with team members and management, assist with cross-training, and recommend workflow improvements to increase efficiency and effectiveness.