Healthcare Call Center Representative

Gainwell Technologies

. Handle inbound and/or outbound calls related to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries .

Posted 10/2/2026full-timeRemote • Texas • United StatesJuniorWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates expertise in handling customer inquiries related to healthcare services, Medicaid, and claims while adhering to HIPAA and data privacy regulations. Proficient in using contact center platforms and Microsoft Office to support operational objectives and enhance customer satisfaction.

Highest-signal resume keywords

Contact Center ExperienceMedicaid SupportNICE Platform ProficiencyStrong Verbal CommunicationProblem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Customer ServiceClaims ProcessingData EntryDocumentationMicrosoft Office ProficiencyMulti-System NavigationQuality AssuranceProductivity StandardsHIPAA ComplianceCritical Thinking

Soft Skills

Active ListeningAttention to DetailOrganizational SkillsTime ManagementCollaboration

Tools & Technologies

CXoneAvayaVerintContact Center PlatformsKnowledge Bases

Industry Keywords

Healthcare OperationsProvider ServicesCustomer InquiriesData PrivacyRemote Work

About the role

Key responsibilities & impact

Handle inbound and/or outbound calls related to healthcare services, Medicaid, eligibility, claims, billing, and provider inquiries
Assess customer needs and resolve questions or concerns during the first interaction whenever possible
Research inquiries using job aids, knowledge bases, contact center platforms, and other system tools
Escalate complex or unresolved issues through established escalation paths
Document customer interactions completely and accurately in required systems
Meet productivity and quality standards, including Average Handle Time, Quality Assurance scores, and schedule adherence
Identify recurring customer concerns, trends, and themes and communicate them to appropriate team members
Follow HIPAA, data privacy, security, and confidentiality requirements when handling protected or sensitive information
Collaborate with peers, supervisors, and team leads to resolve customer inquiries and support operational objectives
Participate in cross-training, knowledge-sharing activities, and other auxiliary functions as necessary
Support the Ohio Fiscal Intermediary account on a fully remote schedule, Monday through Friday, 8:00 a.m. to 4:30 p.m. Eastern Time, or as required by business needs

Requirements

What you’ll need

At least one year of contact center or customer service experience
Experience supporting Medicaid, provider services, healthcare operations, or a related healthcare environment is preferred
Experience using contact center platforms such as NICE, CXone, Avaya, Verint, or similar tools
Basic to intermediate proficiency in Microsoft Office
Ability to navigate multiple systems simultaneously
Strong verbal communication and active listening skills
Strong attention to detail and organizational skills
Ability to manage multiple tasks accurately in a fast-paced environment
Effective problem-solving and critical-thinking skills
Must meet remote-work technology requirements, including a wired Ethernet connection and a minimum internet speed of 150 Mbps
Must complete the required assessment as part of the interview process
Video camera required during all interviews and the initial week of orientation

Benefits

Comp & perks

Work flexibility
Learning and career development opportunities
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies