Healthcare Customer Service Representative - Tallahassee, FL - Hybrid

Gainwell Technologies LLC•Tallahassee, FL

3d•$37,440 - $41,600•Hybrid

About The Position

As a Healthcare Customer Service Representative - Tallahassee, FL - Hybrid at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Requirements

2 or more years of customer service experience in any industry
Knowledge of basic help desk software, computer software and Microsoft Office applications
Strong problem-solving skills to bring inquiries to effective resolution
Strong customer service skills with an emphasis on written and oral communication to respond to inquiries professionally
Ability to understand your role on a team and identify the correct stakeholders to consult to resolve client inquiries
Call Center Hours of Operation: 7:00 AM – 6:00 PM candidate must be able to work any assigned 8 hour shift between these hours.
This is a remote position for candidates living in the state of Florida
Video cameras must be used during all interviews, as well as during the initial week of orientation.
Full-time (40 hours a week)
Remote (work from home)
In order to effectively work as a teleworker with Gainwell, employees Broadband Internet connections, should have a minimum speed of 24MBS download and 8 MBS upload. Greater speeds will of course provide better performance.

Responsibilities

Answers telephones and responds to basic customer questions and/or forwards to appropriate personnel and provides consultancy utilizing knowledge and expertise on insurance and healthcare.
Develops and implements general insurance and health care policies in accordance with state and federal laws and provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions.
Responds to provider appeals and meets with providers to resolve problems/issues. Advises provider review councils, state officials and works with organized healthcare groups and associations on various medical issues related to insurance and healthcare programs.
Processes calls in a manner that ensures service level agreements (SLAs) are met or exceeded. Records calls, processes requests and updates account history with results of inquiry to include proper documentation.
Interfaces with team members, management, and customers in reference to customer service issues. Review and recommends modification to procedures and workflow as necessary to ensure efficient and effective processing of transactions.