Healthcare Customer Service Representative Tallahassee Full Time

Summary:

Gainwell Technologies LLC, an industry leader in healthcare technology, offers a fully remote Healthcare Customer Service Representative role based in Tallahassee, FL. Join a team dedicated to improving health outcomes for vulnerable communities through innovative solutions, with opportunities for career growth, flexibility, and skill development in a collaborative, inclusive workplace.

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.
• Process client inquiries more efficiently and effectively by reviewing and recommending changes to procedures and workflow.

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.
• Hours of Operation: 8:00 AM ET – 5:00 00 PM ET candidate must be able to work any assigned 8-hour shift between these hours.

Benefits:

• 401(k) matching.
• Health insurance.
• Tuition reimbursement.
• Generous, flexible vacation policy.
• Comprehensive health benefits.
• Educational assistance.
• Variety of leadership and technical development academies to help build your skills and capabilities.