Healthcare Call Center Representative - Remote

Gainwell Technologies LLC•Any city, OH
•Remote

About The Position

As a Healthcare Call Center Representative - Remote 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.

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

Benefits

  • flexible vacation policy
  • 401(k) employer match
  • comprehensive health benefits
  • educational assistance
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