Medical Contact Center Representative – Inbound/Outbound
Employment Information
Report this job
Job expired or something wrong with this job?
Job Description
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.
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 to Customers’ needs and concerns, demonstrate empathy and patience, build rapport, and establish trust
- Help Customers navigate healthcare processes, benefits, care programs, internal processes, and available resources
- Answer inquiries about benefits, claims, eligibility, provider networks, prior authorizations, preventive health promotion, and other healthcare topics
- Research, resolve, document, and follow up on complex Customer issues, escalating recurring issues and trends to management
- Educate Customers on plan benefits, policies, procedures, self-service portals, and healthcare information
- Conduct outbound enrollment outreach for care management and care coordination programs
- Conduct clinical quality and wellness outreach, including medication refill reminders, blood pressure check-ins, preventive care reminders, gap-in-care closure, and wellness check-ins
- Handle inbound calls from prospective enrollees, qualify interest, explain program value, and guide next steps
- Use approved scripts, talking points, call flows, and dialer-based 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, and company policies
- Support Claims, Utilization Management, Intake, Quality, Care Management, and Patient Engagement departments
- Meet performance goals for CSAT, first contact resolution, quality, efficiency, attendance, and schedule adherence
- Participate in training, coaching, professional development, and continuous improvement initiatives
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 demonstrated customer service skills and passion for helping others
- Strong empathy, patience, rapport-building, 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 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 high accountability
- Ability to handle stressful situations professionally and calmly
- Knowledge of medical terminology, healthcare benefits, and insurance processes
- Ability to protect PHI and comply with HIPAA and applicable laws and regulations
- Ability to work with multiple communication channels
- Bilingual skills are a plus
- Associate's, bachelor's, or master’s degree preferred
Benefits:
- Fully remote work arrangement
- Necessary work equipment provided at no charge to the employee
- Comprehensive 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
- Bi-weekly pay
- Flexible work arrangement reducing commute time
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
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.
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.
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.