Call Center Representative - Warwick, RI - Hybrid

Remote Full-time
About the position

Join a team that drives healthcare service excellence for Rhode Island Medicaid members and providers. As atCall Center Representative, you’ll respond to claims, billing, and eligibility inquiries from physicians, hospitals, and other healthcare providers. This position combines customer service expertise with problem-solving skills to deliver timely, accurate support. You’ll also assist members with benefit plan selections, premium updates, and related program inquiries while maintaining a strong commitment to quality and professionalism.tYour role in our mission
Answer 40–50 inbound calls daily from providers and Medicaid members, delivering clear, accurate, and empathetic assistance.

Research and resolve eligibility, billing, and claim-related questions using available resources and Medicaid guidelines.

Document all inquiries and outcomes within the system, ensuring timely follow-up and resolution.

Support enrollment activities by processing updates, mailing provider correspondence, and assisting with quality control checks.

Train and assist new team members to ensure consistent service delivery and knowledge sharing.

Responsibilities
• Answer 40–50 inbound calls daily from providers and Medicaid members, delivering clear, accurate, and empathetic assistance.
• Research and resolve eligibility, billing, and claim-related questions using available resources and Medicaid guidelines.
• Document all inquiries and outcomes within the system, ensuring timely follow-up and resolution.
• Support enrollment activities by processing updates, mailing provider correspondence, and assisting with quality control checks.
• Train and assist new team members to ensure consistent service delivery and knowledge sharing.

Requirements
• Two or more years of customer service experience, either face-to-face or by phone, preferably in a healthcare or call center setting.
• Strong communication and active listening skills with the ability to handle complex or sensitive inquiries.
• Detail-oriented, dependable, and capable of managing multiple tasks in a fast-paced environment.
• Proficient in computer systems and data entry with solid typing skills.

Nice-to-haves
• Previous medical, insurance, or medical billing experience preferred but not required.

Benefits
• flexible vacation policy
• 401(k) employer match
• comprehensive health benefits
• educational assistance
• leadership and technical development academies

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