Medical Contact Center Representative – Inbound/Outbound

Job not on LinkedIn

🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

💵 $20 - $22 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

📞 Call Center Representative

🚫👨‍🎓 No degree required

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Guide Healthcare

WebsiteLinkedInAll Job Openings

51 - 200 employees

Founded 2018

⚕️ Healthcare Insurance

🏥 Healthcare

🎯 Recruiter

Healthcare Insurance • Healthcare • Recruitment

Guide Healthcare is leading a movement where creativity delivers positive change in the healthcare sector. The company specializes in allied health service provision and healthcare recruitment, focusing on the support and treatment of older adults. With a commitment to adding value to their clients, partners, and teams, Guide Healthcare aims to do things differently in the industry.

📋 Description

• Provide friendly, accurate, and timely service to members/patients, providers, and other stakeholders through inbound and outbound phone, email, chat, SMS, video calls, and co-browser interactions • Listen to Customers’ needs, demonstrate empathy, build rapport, establish trust, and provide personalized support • Help Customers navigate healthcare processes, benefits, care programs, internal resources, and self-service portals • Protect customer privacy and PHI while complying with HIPAA and applicable laws and regulations • Answer questions about benefits, claims, eligibility, provider networks, prior authorizations, preventive health, and other healthcare topics • Research and resolve complex issues, document interactions and resolutions, and escalate recurring issues or urgent clinical and behavioral health concerns • Educate Customers about plan benefits, policies, procedures, and care-management programs • Conduct outbound enrollment, medication refill, blood pressure, preventive-care, gap-in-care, and wellness outreach • Handle inbound inquiries from prospective enrollees and guide them through care-management program enrollment • Follow approved scripts, call flows, disclosures, TCPA requirements, state do-not-call rules, and dialer workflows • Meet customer satisfaction, first-contact resolution, quality, efficiency, attendance, productivity, and schedule-adherence targets • Support Claims, Utilization Management, Intake, Quality, Care Management, and Patient Engagement departments • Participate in training, coaching, professional development, and continuous-improvement initiatives

🎯 Requirements

• High school diploma or equivalent required • Minimum 2 years of experience in customer service in a health plan, HMO, TPA, or healthcare setting; or program enrollment, telemarketing, cold calling, appointment setting, inside sales, or other outbound calling roles • Minimum 1 year of experience in a healthcare contact center or outbound calling environment • Demonstrated customer service skills and passion for helping others • Strong empathy, patience, rapport-building, persuasion, objection-handling, problem-solving, and critical-thinking skills • Excellent verbal and written communication, grammar, and pronunciation in English • Comfort with structured outbound calling, scripted call flows, and dialer-based workflows • Ability to navigate complex systems and processes • Proficiency with computer systems, CRM software, and Microsoft Office Suite • Ability to learn and retain information quickly • Ability to work independently and as part of a team • Ability to handle stressful situations professionally and calmly • Knowledge of medical terminology, healthcare benefits, and insurance processes • Ability to protect PHI and comply with HIPAA, TCPA, state do-not-call rules, and other regulations • Ability to meet performance goals for CSAT, first-contact resolution, quality, efficiency, attendance, and schedule adherence • Own internet connection with minimum 100 Mbps download and 10 Mbps upload • Bilingual skills are a plus • Associate’s, bachelor’s, or master’s degree preferred

🏖️ Benefits

• Work from home / fully remote work • Medical insurance • Dental insurance • Vision insurance • 401(k) plan with a 3% employer match to a 6% contribution • Life and disability insurance • Voluntary life insurance options • Employee Assistance Program (EAP) • Paid time off plans • Paid parental leave • Learning and development resources • Necessary work equipment provided at no charge • Flexible remote work arrangement • Full-time employees working 30 hours per week or more are eligible for comprehensive benefits