Healthcare Contact Center Agent - Remote US

Summary

Gainwell Technologies is a healthcare technology company seeking a Healthcare Contact Center Agent to provide customer service to members, providers, and other stakeholders. The role handles inbound and outbound calls, electronic correspondence, claims research, insurance verification, inquiry resolution, documentation, and compliance with healthcare regulations.

Responsibilities

• Answer incoming calls promptly and professionally, addressing member or provider inquiries, and make outbound calls as needed. Ability to remain calm and professional in high pressure situations
• Accurately document all interactions in the system, ensuring records are updated and complete
• Maintain confidentiality and comply with HIPAA and other healthcare regulations
• Escalate complex issues to supervisors or appropriate departments when necessary
• Meet or exceed performance metrics including adhering to standardized call scripting and quality guidelines, call handle time, customer satisfaction and adhere to a daily work, lunch and break schedule

Skills

• High school diploma or equivalent required
• 1+ year of experience in a call center or customer service role, preferably in a healthcare setting
• Knowledge of Medicaid/Medicare programs, state healthcare guidelines, or willingness to quickly learn complex program policies
• Strong communication with ability to show empathy and active listening skills to understand member and provider concerns and respond with compassion and clarity
• Demonstrate high attention to detail for compliance-driven processes, along with conflict resolution skills when speaking to frustrated providers or members
• Must be able to speak, read and write proficient English
• Ability to multitask and navigate multiple systems simultaneously and proficiency in Microsoft office and call center software
• Candidates must be available to work a designated 8.5 hour shift Monday - Friday between 7am to 6pm Eastern
• Ability to remain in a stationary position (sitting or standing) for extended periods of time while using a computer and telephone headset
• Ability to operate standard office equipment, including computer, keyboard, mouse, and telephone
• Regular attendance and punctuality are essential to meet adherence and service level requirements
• Associate degree or healthcare certification preferred
• Knowledge of Medicaid/Medicare programs, state healthcare guidelines, or willingness to quickly learn complex program policies
• Bilingual is a plus
• Familiarity with medical terminology and insurance processes is a plus

Qualifications

Must Haves

• High school diploma or equivalent required
• 1+ year of experience in a call center or customer service role, preferably in a healthcare setting
• Knowledge of Medicaid/Medicare programs, state healthcare guidelines, or willingness to quickly learn complex program policies
• Strong communication with ability to show empathy and active listening skills to understand member and provider concerns and respond with compassion and clarity
• Demonstrate high attention to detail for compliance-driven processes, along with conflict resolution skills when speaking to frustrated providers or members
• Must be able to speak, read and write proficient English
• Ability to multitask and navigate multiple systems simultaneously and proficiency in Microsoft office and call center software
• Candidates must be available to work a designated 8.5 hour shift Monday - Friday between 7am to 6pm Eastern
• Ability to remain in a stationary position (sitting or standing) for extended periods of time while using a computer and telephone headset
• Ability to operate standard office equipment, including computer, keyboard, mouse, and telephone
• Regular attendance and punctuality are essential to meet adherence and service level requirements

Nice to Haves

• associate degree or healthcare certification preferred
• Knowledge of Medicaid/Medicare programs, state healthcare guidelines, or willingness to quickly learn complex program policies
• Bilingual is a plus
• Familiarity with medical terminology and insurance processes is a plus

Benefits

• Work flexibility
• Learning and career development
• All salaried, full-time candidates are eligible for our generous, flexible vacation policy
• All salaried, full-time candidates are eligible for a 401(k) employer match
• All salaried, full-time candidates are eligible for comprehensive health benefits
• All salaried, full-time candidates are eligible for educational assistance
• All salaried, full-time candidates are eligible for a variety of leadership and technical development academies to help build your skills and capabilities