Inbound Call Center - Customer Service Representative

Vitalizing Business Solutions Inc.; Winchester (KY); On-site; USD 42,000 - 54,000; Full time

Job summary

Vitalizing Business Solutions Inc. is seeking an on-site Customer Support representative in Winchester, KY to assist Medicare/Medicaid beneficiaries with benefits, eligibility, claims, and coverage. You will address inquiries with empathy and professionalism, ensuring callers feel heard and valued.

You will document interactions in the CRM, support enrollment processes, and escalate complex issues when needed, while maintaining up-to-date CMS training and compliance with HIPAA guidelines.

Qualifications

• High School Diploma or GED required.
• Minimum of 1 year of customer service experience.
• Must be able to speak and read English clearly, professionally, and fluently.
• Excellent verbal and written communication skills.
• Strong active listening skills and empathy.
• Experience with handling escalations, ensuring quality service, and improving customer experience.
• Must work on-site at the Winchester, Kentucky office location.
• Must complete and certify in all required internal training programs, including CMS Medicare and Medicaid specific training.

Responsibilities

• Customer Support: Answer inbound calls from Medicare and Medicaid recipients regarding benefits, eligibility, claims, coverage, and related programs.
• Customer Service: Assist beneficiaries with understanding statements, enrollment processes, and locating providers; strive for first call resolution.

Skills

Active listening

Empathy

Verbal communication

Written communication

Data entry

MS Office

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Job description

• Customer Support: Answer inbound calls from Medicare and Medicaid recipients (and potentially family members or caregivers) regarding their benefits, eligibility, claims, coverage, and related programs. Address inquires, concerns, and complaints with empathy and professionalism, ensuring each caller feels heard and valued.
• Customer Service: Assist beneficiaries with understanding their statements, navigating enrollment processes, and locating providers. Identify customer needs and offer appropriate solutions or guidance, striving for first call resolution whenever possible.
• Compliance and Quality: Adhere strictly to CMS regulations, HIPAA guidelines, and company policies to ensure security and confidentiality beneficiary information.
• Documentation and Data Entry: Accurately document all caller interactions, inquires, and resolutions in the Customer Relationship Management (CRM) system and other relevant databases. Enter and update beneficiary information with the precision and attention to detail.
• Problem Resolution and Escalation: Analyze problems and determine the best solution or path to resolution, escalating complex issues to supervisors or specialized teams when necessary. Assure timely follow-up on pending cases and communicate expected resolution times to beneficiaries.
• Continuous Learning: Maintain up-to-date knowledge of evolving CMS regulations, policies, and program updates. Participate actively in on-going training and development programs to enhance skills and knowledge.

Qualifications

• High School Diploma or GED required.
• Minimum of 1 year of customer service experience, preferably a call center, healthcare, or government- regulated environment.
• Must be able to speak and read English clearly, professionally, and fluently
• Excellent verbal and written communication skills.
• Strong active listening skills and empathy.
• Experience with handling escalations, ensuring quality service, and improving customer experience.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint).
• May be required to work overtime and scheduled holidays.
• Must work on-site at the Winchester, Kentucky office location.
• Must complete and certify in all required internal training programs, including CMS Medicare and Medicaid specific training.
• Must have the ability to work as a member of a team and collaborate with colleagues.
• Must have the ability to navigate multiple computer systems and enter data accurately while speaking with callers.