Medical Contact Center Representative – Inbound and Outbound
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
Medical contact center representative supporting Guidehealth, a data-powered healthcare company, through member service, benefits education, and care-program enrollment. Handling inbound inquiries and outbound clinical wellness outreach remotely.
Responsibilities:
- Provide friendly, accurate, and timely service to members/patients, providers, and other stakeholders through inbound and outbound phone, email, chat, SMS, video calls, co-browser sessions, and other channels
- Listen actively, demonstrate empathy and patience, build rapport, establish trust, and deliver personalized customer experiences
- Help customers navigate internal processes, resources, healthcare benefits, and care management programs
- Answer inquiries about benefits, claims, eligibility, provider networks, prior authorizations, preventive health promotion, and healthcare topics
- Research, resolve, document, and follow through on complex customer issues, escalating recurring issues and trends to management
- Educate customers about plan benefits, policies, procedures, self-service portals, and available resources
- Conduct outbound enrollment outreach for care management and care coordination programs
- Conduct clinical quality and wellness outreach, including medication refill reminders, blood pressure checks, preventive care reminders, gap-in-care closure, and wellness check-ins
- Handle inbound inquiries from prospective enrollees and guide them through program enrollment steps
- Explain program value, features, and benefits; address hesitation and objections with empathy
- Follow approved scripts, talking points, and call flows while adapting communication to each member
- Operate dialer-based outbound workflows, manage call dispositions, and meet productivity and quality targets
- Escalate clinical, behavioral health, and urgent member concerns appropriately
- Comply with TCPA, state do-not-call rules, HIPAA, company policies, and applicable regulations
- Support departments including Claims, Utilization Management, Intake, Quality, Care Management, and Patient Engagement
- Meet goals for customer satisfaction, first contact resolution, quality, efficiency, attendance, and schedule adherence
- Participate in training and development and contribute improvement ideas
Requirements:
- High school diploma or equivalent required
- Minimum of 2 years of experience in customer service in a health plan, HMO, TPA, or healthcare setting; or program enrollment, telemarketing, cold calling, appointment setting, inside sales, or other outbound calling roles
- Minimum of 1 year of experience in a healthcare contact center or outbound calling environment
- Exceptional customer service skills and passion for helping others
- Strong empathy, patience, rapport-building, active listening, persuasion, objection-handling, problem-solving, and critical-thinking skills
- Excellent verbal and written communication, grammar, and English pronunciation
- Ability to communicate clearly, concisely, and professionally
- Comfort with structured outbound calling, scripted call flows, and dialer-based workflows
- Ability to handle refusals, voicemails, unanswered calls, and repetitive dialing volume professionally
- Ability to navigate complex systems and processes
- Proficiency with computer systems, CRM software, and Microsoft Office Suite
- Ability to learn and retain information quickly
- Ability to work independently and as part of a team with a high level of accountability
- Ability to handle stressful situations with professionalism and composure
- Knowledge of medical terminology, healthcare benefits, and insurance processes
- Bilingual skills are a plus
- Associate's, bachelor's, or master's degree preferred
- Ability to provide an internet connection with at least 100 Mbps download and 10 Mbps upload
Benefits:
- Fully remote work / work from home
- Necessary equipment provided at no charge to the employee
- Medical, dental, and vision plans
- 401(k) plan with a 3% employer match to a 6% employee contribution
- Life and disability insurance
- Voluntary life insurance options
- Employee Assistance Program (EAP)
- Paid time off plans
- Paid parental leave
- Learning and development resources
- Full-time employees working 30 or more hours per week are eligible for the comprehensive benefits package
Similar Jobs
Trabajades de Casa / Asesor Comercial, Call Center
Asesor Comercial remoto para Partner Service, contactando clientes de Claro para vender renovaciones de equipos y upgrades de servicios hogar. Gestión de ventas, retención y atención al cliente en contact center.
Teleoperador, retenciones, con experiencia en call center
Teleoperador remoto reteniendo clientes postpago de Claro para Partner Service, empresa de outsourcing y telecomunicaciones. Ofreciendo promociones y descuentos mediante llamadas de retención.
Asesor de Call Center, Gestión Remota, 6 horas
Asesor remoto de call center para Partner Service, empresa de telecomunicaciones. Renovando equipos móviles, ofreciendo líneas adicionales y seguros de protección para Claro Perú.
Asesor Call Center Retenciones, Semi y Full Time
Teleoperador remoto de retenciones para Partner Service, empresa de telecomunicaciones. Fidelización de clientes y cierre de renovaciones o cambios de plan.
Teleoperador – Planilla Completa
Teleoperador remoto en NetCall Perú, empresa de telecomunicaciones. Contactando clientes de otras operadoras para vender portabilidad Entel a nivel nacional.
Teleoperador de Ventas, Portabilidad
Teleoperador remoto de NetCall Perú, empresa de telecomunicaciones, vendiendo portabilidades y servicios Entel a clientes interesados. Gestión de llamadas click to call desde casa a nivel nacional.
Healthcare Contact Center Representative – Inbound and Outbound
Healthcare contact center representative guiding patients through benefits, enrollment, and care programs at Guidehealth. Handling inbound and outbound interactions across phone and digital channels for a data-powered healthcare company.
Medical Contact Center Representative – Inbound and Outbound
Remote contact center representative guiding U.S. healthcare members through benefits, enrollment, and care-management programs. Handling inbound support and outbound clinical-quality outreach for Guidehealth, a value-based healthcare company.
Medical Contact Center Representative – Inbound and Outbound
Medical contact center representative guiding patients through healthcare benefits and care programs at Guidehealth. Handling inbound service, outbound enrollment, and clinical wellness outreach remotely.
Medical Contact Center Representative – Inbound and Outbound
Remote healthcare contact center representative supporting patients and providers. Handling benefits inquiries, care-program enrollment, wellness outreach, and issue resolution across multiple channels.
Medical Contact Center Representative – Inbound/Outbound
Medical contact center representative guiding U.S. patients through benefits, care management, and wellness programs. Handling inbound support and outbound enrollment and clinical outreach for Guidehealth’s data-powered healthcare services.
Medical Contact Center Representative, Inbound/Outbound
Remote Medical Contact Center Representative serving Guidehealth members and providers. Handling healthcare inquiries, benefits education, enrollment outreach, and clinical wellness calls.
Medical Contact Center Representative, Inbound/Outbound
Medical contact center representative supporting Guidehealth’s data-powered healthcare services. Guiding patients through benefits, care programs, enrollment, and wellness outreach via multiple communication channels.
Medical Contact Center Representative – Inbound/Outbound
Remote Medical Contact Center Representative for Guidehealth, a data-powered healthcare company. Guiding members through benefits, enrollment, care management, and wellness programs via inbound and outbound channels.
Call Center Agent, Outbound Sales
Outbound-Sales-Call-Center-Agent für Avedo, eine Kundenservice-Marke der Ströer X GmbH. Telefonische Beratung und Verkauf von Verlags- und Fachinformationsprodukten auf Deutsch.
Asesor de Call Center, 6 horas
Asesor de call center remoto para Partner Service, empresa de telecomunicaciones. Renovando equipos móviles Claro Perú y ofreciendo líneas adicionales y seguros.
Call Centre Agent
Remote Call Centre Agent in South Africa handling inbound and outbound calls for UK customers. Managing bookings, queries, updates, follow-ups, and accurate call records.
Asesor de Ventas – Call Center, Full time
Teleoperador remoto de Netcall, empresa peruana de telecomunicaciones, vendiendo líneas nuevas, renovaciones y portabilidad de Entel. Gestionando llamadas a clientes y no clientes dentro de un horario full time rotativo.
Asesor(a) de Ventas, Call Center
Teleoperador remoto de ventas para Netcall, empresa peruana de telecomunicaciones y socio de Entel. Gestionando llamadas sobre líneas nuevas, renovaciones y portabilidad.
Asesor(a) de Ventas, Call Center, Full time
Teleoperador remoto realizando ventas telefónicas de líneas nuevas, renovaciones y portabilidad para Entel. Netcall Group, empresa peruana de telecomunicaciones, ofrece sueldo fijo, comisiones y capacitación pagada.