Medicaid Customer Service Representative

Moda Health•Milwaukie, OR

10d•Remote

About The Position

Moda is seeking a Medicaid Customer Service Representative to provide customer service to Oregon Health Plan (OHP) members. This full-time, work-from-home position requires availability Monday through Friday from 7:30 AM to 5:30 PM. The hourly pay range is $18.39–$20.58, depending on qualifications. The representative answers a high volume of calls, provides information about OHP medical and pharmacy benefits, researches and resolves inquiries, and documents interactions using software tools. The role requires protecting confidential information and complying with privacy policies and HIPAA regulations, while collaborating with a team and adapting to changing customer needs. Moda provides comprehensive training and opportunities for career advancement.

Requirements

At least 1 year of experience in a medical insurance or healthcare-related field.
At least 1 year of call center or customer service experience.
High school diploma or equivalent.
Strong computer skills, including typing, 10-key, and Microsoft Office proficiency.
Ability to meet Moda’s attendance and punctuality standards consistently.
High-speed internet via cable or fiber.

Nice To Haves

Experience with medical health insurance or government healthcare programs.
Knowledge of medical terminology.
Medical billing and coding experience.
Experience with a trauma-informed care model.

Responsibilities

Answer a high volume of calls professionally and empathetically, working to resolve customer concerns.
Provide accurate and timely information about OHP medical and pharmacy benefits.
Research and resolve complex inquiries to support customer satisfaction.
Maintain confidentiality and follow privacy policies and HIPAA regulations.
Document calls thoroughly and efficiently using software tools.
Collaborate with the team and experienced leadership to achieve good outcomes.
Adapt to evolving customer needs in a dynamic work environment.