Medical Contact Center Representative, Inbound/Outbound

Job not on LinkedIn

🔥 0 minutes ago

🏰 Missouri – Remote

🏰 Missouri – 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 interactions via phone, email, chat, SMS, video calls, co-browser sessions, and other channels • Listen to Customers’ needs and concerns, demonstrate empathy, build rapport, and establish trust • Help Customers navigate internal processes, benefits, care programs, and available resources • Protect privacy, dignity, and PHI while complying with HIPAA and applicable laws and regulations • Support departments including Claims, Utilization Management, Intake, Quality, Care Management, and Patient Engagement • Answer inquiries about benefits, claims, eligibility, provider networks, prior authorizations, preventive health promotion, and healthcare topics • Research, resolve, document, and follow up on complex Customer issues; escalate recurring issues and trends • Educate Customers about plan benefits, policies, procedures, self-service portals, and available resources • Conduct outbound enrollment outreach for care management and care coordination programs • Conduct clinical quality and wellness outreach, including medication refill reminders, blood pressure check-ins, preventive care reminders, gap-in-care closure, and wellness check-ins • Handle inbound inquiries from prospective enrollees and guide them through next steps • Explain program value, features, and benefits; address hesitation and objections using approved scripts and call flows • Operate dialer-based outbound workflows, manage call dispositions, and meet outreach productivity and quality targets • Escalate clinical, behavioral health, and urgent member needs appropriately • Meet performance goals for CSAT, first contact resolution, quality, efficiency, attendance, and schedule adherence • Participate in training, coaching, professional development, and process improvement initiatives

🎯 Requirements

• High school diploma or equivalent required • Minimum of 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 of 1 year of experience in a healthcare contact center or outbound calling environment • Exceptional demonstrated customer service skills and passion for helping others • Strong empathy, patience, rapport-building, active listening, problem-solving, and critical-thinking skills • Excellent verbal and written communication, grammar, and pronunciation in English • Strong persuasion and objection-handling skills • 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 with high accountability • Ability to handle stressful situations professionally and calmly • Knowledge of medical terminology, healthcare benefits, and insurance processes • Must provide an internet connection with minimum 100 Mbps download and 10 Mbps upload, capable of video calls and system connectivity • Bilingual skills are a plus • Associate's, bachelor's, or master’s degree preferred

🏖️ Benefits

• Fully remote work arrangement • Medical, Dental, and Vision plans • 401(k) plan with a 3% employer match to your 6% contribution • Life and Disability insurance • Voluntary Life options • Employee Assistance Program (EAP) • Paid time off plans • Paid parental leave • Learning and development resources • Necessary work equipment provided at no charge to the employee