Note: The job is a remote job and is open to candidates in USA. Gainwell Technologies is a healthcare technology company that helps clients improve the health and well-being of the members they serve. The Healthcare Call Center Representative handles healthcare-related customer calls, researches and resolves inquiries, documents interactions, escalates complex issues, and supports operational objectives while maintaining quality, productivity, privacy, and security standards.

Responsibilities

• Handle inbound and/or outbound calls related to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries
• Assess customer needs and work to resolve questions or concerns during the first interaction whenever possible
• Research inquiries using job aids, knowledge bases, contact center platforms, and other available system tools
• Escalate complex or unresolved issues through established escalation paths
• Document customer interactions completely and accurately in all required systems
• Meet established productivity and quality standards, including Average Handle Time, Quality Assurance scores, and schedule adherence
• Identify recurring customer concerns, trends, and themes and communicate them to the appropriate team members
• Follow HIPAA, data privacy, security, and confidentiality requirements when handling protected or sensitive information
• Collaborate with peers, supervisors, and team leads to resolve customer inquiries and support operational objectives
• Participate in cross-training, knowledge-sharing activities, and other auxiliary functions as necessary

Skills

• At least one year of contact center or customer service experience
• Experience using contact center platforms such as NICE, CXone, Avaya, Verint, or similar tools, along with basic to intermediate proficiency in Microsoft Office and the ability to navigate multiple systems simultaneously
• Strong verbal communication and active listening skills, with the ability to communicate information clearly and professionally
• Strong attention to detail, organizational skills, and the ability to manage multiple tasks accurately in a fast-paced environment
• Effective problem-solving and critical-thinking skills, with the ability to assess customer needs, research information, and determine the appropriate resolution
• Experience supporting Medicaid, provider services, healthcare operations, or a related healthcare environment

Benefits

• Fully remote position
• All salaried, full-time candidates are eligible for a 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
• A variety of leadership and technical development academies to help build skills and capabilities

Company Overview

Company H1B Sponsorship