Healthcare Call Center Representative - Remote

Gainwell Technologies; Texas; Remote; USD 38,000 - 46,000; Full time

Benefits offered by this job

401(k) match

Health benefits

Education assistance

Vacation policy

Development academies

Job summary

Gainwell Technologies is seeking a Healthcare Call Center Representative - Remote to join a privacy-conscious, patient-focused team. You will handle healthcare-related inquiries, Medicaid, eligibility, and billing, using contact center platforms to resolve issues with efficiency and empathy.

This fully remote role requires excellent communication, attention to detail, and the ability to manage multiple systems.

Qualifications

• At least 1 year in a contact center or customer service.
• Experience with Medicaid/provider services preferred.
• Strong communication and listening skills.
• Able to navigate multiple systems.

Responsibilities

• Handle inbound/outbound calls related to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries.
• Assess customer needs and resolve questions during first interaction when possible.
• Research inquiries using job aids, knowledge bases, and system tools.
• Escalate complex issues through established paths.
• Document customer interactions accurately in required systems.
• Meet productivity and quality standards including AHT, QA, and schedule adherence.
• Identify recurring concerns and communicate trends to the team.
• Follow HIPAA, data privacy and confidentiality requirements.
• Collaborate with peers and leads to support objectives.
• Participate in cross-training and knowledge-sharing activities.

Skills

Call center experience

Medicaid knowledge

Healthcare operations

NICE CXone

Avaya

Verint

Microsoft Office

Active listening

Verbal communication

Multi-system navigation

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

As a Healthcare Call Center Representative - Remote at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

• 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

What We're Looking For

• At least one year of contact center or customer service experience; experience supporting Medicaid, provider services, healthcare operations, or a related healthcare environment is preferred
• 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.

What You Should Expect In This Role

• This is a fully remote position supporting the Ohio Fiscal Intermediary account.
• Work schedule is Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern Time, or as required by business needs.
• Must meet remote-work technology requirements, including a wired Ethernet connection and a minimum internet speed of 150 Mbps
• As part of our interview process, all candidates must complete the Assessment. This assessment helps us evaluate key competencies relevant to the role, including communication skills, multitasking abilities, and problem-solving capabilities.
• Video cameras must be used during all interviews, as well as during the initial week of orientation.

This posting is intended for pipelining. We will accept applications on an ongoing basis.

The pay range for this position is [[salaryMin]] - [[salaryMid]] per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, 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 company website and visit our Careers site 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.