Healthcare Contact Center Agent
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Job Description
Healthcare Call Center Agent providing exceptional customer service to members and providers. Involves handling calls, researching claims, and ensuring compliance with healthcare regulations.
Responsibilities:
- Answer incoming calls promptly and professionally, addressing member or provider inquiries, and make outbound calls as needed.
- Ability to remain calm and professional in high-pressure situations.
- Accurately document all interactions in the system, ensuring records are updated and complete.
- Maintain confidentiality and comply with HIPAA and other healthcare regulations.
- Escalate complex issues to supervisors or appropriate departments when necessary.
- Meet or exceed performance metrics including adhering to standardized call scripting and quality guidelines, call handle time, customer satisfaction and adhere to a daily work, lunch and break schedule.
Requirements:
- High school diploma or equivalent required; associate degree or healthcare certification preferred.
- 1+ year of experience in a call center or customer service role, preferably in a healthcare setting.
- Knowledge of Medicaid/Medicare programs, state healthcare guidelines, or willingness to quickly learn complex program policies.
- Strong communication with ability to show empathy and active listening skills to understand member and provider concerns and respond with compassion and clarity.
- Demonstrate high attention to detail for compliance-driven processes, along with conflict resolution skills when speaking to frustrated providers or members.
- Must be able to speak, read and write proficient English. Bilingual is a plus.
- Ability to multitask and navigate multiple systems simultaneously and proficiency in Microsoft Office and call center software.
- Familiarity with medical terminology and insurance processes is a plus.
Benefits:
- Flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- Leadership and technical development academies
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