Medical Contact Center Representative, Inbound/Outbound

Job not on LinkedIn

🔥 0 minutes ago

🤠 Texas – Remote

🤠 Texas – 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 stakeholders through inbound and outbound phone, email, chat, SMS, video calls, and co-browser sessions • Listen actively, demonstrate empathy and patience, build rapport, and establish trust with Customers • Help Customers navigate healthcare processes, benefits, care programs, internal processes, and available resources • Answer inquiries about benefits, claims, eligibility, provider networks, prior authorizations, preventive health promotion, and other healthcare topics • Research, resolve, document, and follow up on complex Customer issues and escalate recurring trends or urgent concerns • Educate Customers about plan benefits, policies, procedures, self-service portals, and healthcare information • 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, qualify interest, explain program value, and guide next steps • Follow approved scripts, talking points, call flows, outbound calling regulations, and disclosure standards • Operate dialer-based workflows, manage call dispositions, and meet outreach productivity and quality targets • Escalate clinical, behavioral health, and urgent member needs appropriately • Support Claims, Utilization Management, Intake, Quality, Care Management, and Patient Engagement departments • Meet performance goals for CSAT, first contact resolution, quality, efficiency, attendance, and schedule adherence • Participate in coaching, training, professional development, and continuous 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 customer service skills and passion for helping others • Strong empathy, patience, rapport-building, active listening, and problem-solving skills • Excellent verbal and written communication, grammar, and English pronunciation • Strong persuasion and objection-handling skills • Comfort with structured outbound calling, scripted call flows, and dialer-based workflows • Resilience and professional composure when handling refusals, voicemails, unanswered calls, and repetitive dialing • 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 strong accountability • Ability to handle stressful situations professionally • Knowledge of medical terminology, healthcare benefits, and insurance processes • Ability to work with a minimum 100 Mbps download and 10 Mbps upload internet connection • Bilingual skills are a plus • Associate’s, bachelor’s, or master’s degree preferred

🏖️ Benefits

• Fully remote work / work from home • Medical, dental, and vision plans • 401(k) plan with a 3% employer match to a 6% employee 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 • Virtual meetings with cameras on • Full-time employees working 30 or more hours per week are eligible for the comprehensive benefits package