Healthcare Call Center Representative - Remote

Gainwell Technologies LLC•Any city, OH

1d•$29,100 - $41,600•Remote

About The Position

As a Healthcare Call Center Representative - Remote at Gainwell, you will support the Ohio Fiscal Intermediary account by assisting customers with questions related to healthcare services, eligibility, claims, billing, Medicaid, and provider services. You will serve as a trusted point of contact, assessing customer needs, researching inquiries, and delivering accurate and professional support. In this fully remote role, you will work in a fast-paced contact center environment where service quality, productivity, accuracy, and compliance are essential. You will use multiple systems and resources to resolve inquiries while helping improve the health and well-being of the members and communities we serve.

Requirements

At least one year of contact center or customer service experience
Experience using contact center platforms such as NICE, CXone, Avaya, Verint, or similar tools, along with basic to intermediate proficiency in Microsoft Office and the ability to navigate multiple systems simultaneously
Strong verbal communication and active listening skills, with the ability to communicate information clearly and professionally
Strong attention to detail, organizational skills, and the ability to manage multiple tasks accurately in a fast-paced environment
Effective problem-solving and critical-thinking skills, with the ability to assess customer needs, research information, and determine the appropriate resolution
Must meet remote-work technology requirements, including a wired Ethernet connection and a minimum internet speed of 150 Mbps

Nice To Haves

Experience supporting Medicaid, provider services, healthcare operations, or a related healthcare environment is preferred

Responsibilities

Handle inbound and/or outbound calls related to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries
Assess customer needs and work to resolve questions or concerns during the first interaction whenever possible
Research inquiries using job aids, knowledge bases, contact center platforms, and other available system tools
Escalate complex or unresolved issues through established escalation paths
Document customer interactions completely and accurately in all required systems
Meet established productivity and quality standards, including Average Handle Time, Quality Assurance scores, and schedule adherence
Identify recurring customer concerns, trends, and themes and communicate them to the appropriate team members
Follow HIPAA, data privacy, security, and confidentiality requirements when handling protected or sensitive information
Collaborate with peers, supervisors, and team leads to resolve customer inquiries and support operational objectives
Participate in cross-training, knowledge-sharing activities, and other auxiliary functions as necessary