Medical Contact Center Representative, Inbound and Outbound
Overview
You will be the voice of Guidehealth, guiding patients and providers through healthcare benefits and care management. You will handle inbound and outbound interactions across phone, email, chat, and video, with a focus on enrollment and clinical outreach. You join a remote, data-driven team using AI and predictive analytics to improve outcomes. This role offers a clear path to grow within a mission-driven healthcare company.
What You'll Do9
- 1Handle inbound service calls and program inquiries, providing accurate and empathetic support for benefits, claims, eligibility, and care management.
- 2Conduct outbound enrollment outreach to members, explaining program value and guiding them through sign-up steps using approved scripts.
- 3Perform clinical quality calls, including medication refill reminders, blood pressure checks, and wellness check-ins to close gaps in care.
- 4Document every interaction in CRM systems, ensuring accurate records and HIPAA-compliant handling of PHI.
- 5Resolve complex member issues by collaborating with Claims, Utilization Management, and Care Management teams, ensuring full resolution.
- 6Teach patients to navigate the self-service portal and understand their health benefits, empowering informed decisions.
- 7Escalate urgent clinical or behavioral health concerns per protocol while maintaining professional composure and empathy.
- 8Meet productivity and quality targets while balancing empathy and efficiency in every call.
- 9Adapt quickly to evolving business needs and contribute cross-functionally when required.
Requirements10
- 12+ years of experience in healthcare customer service, or outbound calling such as telemarketing or appointment setting.
- 21+ years experience in a contact center or outbound calling environment.
- 3High school diploma or equivalent required.
- 4Exceptional communication with clear grammar and pronunciation in English.
- 5Proficient in CRM software and Microsoft Office Suite.
- 6Skills in persuasion and objection handling without closing sales.
- 7Working knowledge of medical terminology, health benefits, and insurance processes.
- 8Comfort with dialer-based workflows and scripted calls.
- 9Ability to work independently and as a team, maintaining accountability.
- 10Preferred: bilingual, associate's degree or higher, and experience with inbound/outbound multi-channel support.
Salary Insight
Salary not disclosed in listing
Location
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