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About the Role
As a Healthcare Call Center Representative, you will be the cornerstone of our commitment to customer satisfaction. In this role, you will provide comprehensive support and information to members, providers, and patients, ensuring they get the most out of their healthcare plans and services. Your objective is to deliver extraordinary service while building trust and rapport with current and prospective members.
Responsibilities
- Manage inquiries in areas such as Member Services, Medicare, and Billing.
- Represent our client professionally by addressing and documenting all incoming queries, including complex calls related to specialized product lines.
- Uphold the organization’s philosophy of extraordinary customer relations.
- Proactively engage with Health Plan, medical group, and facility personnel to gather relevant information for resolving member inquiries.
- Analyze and evaluate customer issues to initiate and coordinate service recovery measures.
- Document all member interactions meticulously following established procedures.
- Demonstrate familiarity with health insurance terminology (copays, deductibles, claims, authorizations, etc.).
- Understand Medicare/Medicaid plans and regulations, and explain plan benefits, provider networks, and coverage policies.
- Leverage a thorough understanding of company policies and processes to meet customer needs effectively.
- Contribute to departmental goals and objectives while maintaining proficiency through ongoing training and use of required tools.
- Monitor and achieve Contact Center KPIs, including call handling, first call resolution, and member retention.
- Consistently uphold company compliance standards and Code of Conduct, ensuring privacy and confidentiality of member information.
- Adhere to HIPAA regulations to protect personal health information (PHI) and maintain data security.
- Use multiple systems/screens while assisting callers effectively.
- Navigate CRM, EMR/EHR, and ticketing platforms effectively.
Requirements
- A dedicated, quiet workspace with a door that closes, free from ambient noise.
- A comfortable desk and chair setup that allows for the proper installation of necessary equipment.
- Stable, high-speed internet with a minimum bandwidth of 20 Mbps downstream and 20 Mbps upstream.
- Comfort with technology and ability to learn new systems quickly.
- Ability to stay productive and manage your time effectively in a remote environment.
- Strong verbal and written communication skills, especially in a virtual setting.
- Ability to adapt to changing technologies and procedures while working remotely.
- Minimum of two (2) years of customer service or healthcare member-interaction experience.
- Previous call center experience and/or prior experience in the health insurance industry (preferred).
- Typing speed of at least 35 WPM with a 5% or lower error rate.
Skills
- Exceptional customer service
- Building meaningful relationships
- Comprehensive support and information
- Compliance guidelines
- Trust and rapport building
- Member Services
- Medicare
- Billing
- Professional representation
- Documentation
- Proactive engagement
- Problem analysis
- Service recovery
- Health insurance terminology
- Medicare/Medicaid plans and regulations
- Company policies and processes
- Ongoing training
- Required tools
- Contact Center KPIs
- Call handling
- First call resolution
- Member retention
- Company compliance standards
- Code of Conduct
- Privacy and confidentiality
- HIPAA regulations
- Data security
- Multiple systems/screens
- CRM
- EMR/EHR
- Ticketing platforms
- Tech-savvy
- Self-motivation
- Independence
- Communication skills
- Adaptability
- Written communication skills
- Verbal communication skills
- Analytical abilities
- Problem-solving abilities
- Concise and clear responses
- Critical thinking
Location
- Remote (Virtual Environment)
Work Type
- Remote
- Full-time
Experience Level
- Minimum of two (2) years of customer service or healthcare member-interaction experience
Education Level
- High School Diploma or GED required
Salary/Compensations
- up to USD 16 - hourly
Benefits
- Full health insurance coverage, including medical, dental, and vision plans.
- $25/month per line for unlimited phone, text, and data (restrictions may apply).
- Referral for Life Program™: Earn residual bonuses for referring employees who join the team and remain with the company.
About the Company
- VXI Global Solutions is a BPO leader in customer service, customer experience, and digital solutions.
- Founded in 1998, the company has 40,000 employees in more than 40 locations in North America, Asia, Europe, and the Caribbean.
- We deliver omnichannel and multilingual support, software development, quality assurance, CX advisory, and automation & process excellence to the world's most respected brands.
- VXI is one of the fastest growing, privately-held business services organizations in the United States and the Philippines and one of China's few US-based customer-care organizations.
Equal Opportunity
- We are an Equal Opportunity Employer, welcoming individuals with disabilities and veterans.
- All your information will be kept confidential according to EEO guidelines.