Job Description

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

The Healthcare Call Center Agent is responsible for providing exceptional customer service to members, providers, and other stakeholders by handling inbound and outbound calls, responding to electronic mail, and other methods of secure correspondence. This role involves researching claims, verifying insurance, resolving inquiries, and ensuring compliance with healthcare regulations. The ideal candidate is empathetic, detail-oriented, and committed to delivering a positive contact experience.

Your role in our mission

• 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.

What we're looking for

• High school diploma or equivalent required; associate degree or healthcare certification preferred.
• 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. Bilingual is a plus.
• Ability to multitask and navigate multiple systems simultaneously and proficiency in Microsoft office and call center software.
• Familiarity with medical terminology and insurance processes is a plus.

What you should expect in this role

• 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.
• A fast-paced, metrics driven environment
• Location Remote
• #LI-LS2

The pay range for this position is $27,200.00 - $38,900.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our and visit our for all available job role openings.

Gainwell Technologies  is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.

Job Tags

Similar Jobs