Medicaid Customer Service Representative

Moda Health; Portland (OR); Remote; USD 60,000 - 80,000; Full time

Job summary

Moda Health is seeking a Medicaid Customer Service Representative to deliver exceptional service to Oregon Health Plan members. This full-time work-from-home role requires problem-solving skills and excellent communication. The position offers comprehensive training, professional growth, and a collaborative environment.

Benefits

Medical, Dental, Vision, Pharmacy, Life, & Disability

401K- Matching

FSA

Employee Assistance Program

PTO and Company Paid Holidays

Qualifications

• At least 1 year of experience in a healthcare-related field.
• Minimum 1 year of call center or customer service experience.
• High speed internet required.

Responsibilities

• Answer a high volume of calls with professionalism and empathy.
• Provide accurate and timely information about OHP medical and pharmacy benefits.
• Document calls thoroughly using the latest software tools.

Skills

Communication

Problem-solving

Computer skills

Education

High School Diploma or equivalent

Tools

Microsoft Office

Job description

Let’s do great things, together!

About Moda

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we’re focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together. Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let’s be better together.

Job Summary:
Are you a problem-solver with excellent communication skills who thrives in a fast-paced, team-driven environment?
We’re looking for a Medicaid Customer Service Representative to join our team and deliver exceptional service to members of the Oregon Health Plan (OHP). This is a full-time WFH position with availability required from 7:30 AM–5:30 PM, Monday through Friday.

Pay Range
$19.00 - $20.00 hourly, DOE.
**Actual pay is based on qualifications. Applicants who do not exceed the minimum qualifications will only be eligible for the low end of the pay range.

Position starts July 28, 2025.Please fill out an application on our company page, linked below, to be considered for this position:

https://j.brt.mv/jb.do?reqGK=27756666&refresh=true

Benefits:

1. Medical, Dental, Vision, Pharmacy, Life, & Disability
2. 401K- Matching
3. FSA
4. Employee Assistance Program
5. PTO and Company Paid Holidays

Required Qualifications

• At least 1 year of experience in a medical insurance or healthcare-related field.
• Minimum 1 year of call center or customer service experience.
• High School Diploma or equivalent.
• Strong computer skills, including typing, 10-key, and Microsoft Office proficiency.
• Ability to consistently meet Moda’s attendance and punctuality standards as part of job performance expectations.
• High speed internet (cable or fiber)

Preferred Qualifications

• Experience with medical health insurance or government healthcare programs.
• Knowledge of medical terminology.
• Medical billing and coding experience
• Experience with trauma informed care model

Primary Functions:

• Answer a high volume of calls with professionalism, empathy, and a commitment to solving customer concerns.
• Provide accurate, timely information about OHP medical and pharmacy benefits.
• Research and resolve complex inquiries to ensure customer satisfaction.
• Maintain confidentiality and adhere to privacy policies and HIPAA regulations.
• Document calls thoroughly and efficiently using the latest software tools.
• Collaborate with a supportive team and experienced leadership to ensure the best outcomes.
• Continuously adapt to evolving customer needs in a dynamic work environment.

Why Join Us?

• Comprehensive Training: We’ll set you up for success with the tools and knowledge you need.
• Professional Growth: Explore opportunities for career advancement within a growing organization.
• Collaborative Environment: Be part of a team that values innovation, diversity, and mutual support.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law. This is applicable to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absences, compensation, and training.

For more information regarding accommodations, please direct your questions to Kristy Nehler & Danielle Baker via our [e-mail] email.