Remote - Healthcare Call Center Representative
VXI Global Solutions LLC · Tulsa, OK
Job description
Healthcare Call Center Representative It's fun to work in a company where people truly BELIEVE in what they are doing! We're committed to bringing passion and customer focus to the business. Location: Remote (Virtual Environment) Company: Trusted Leader in Healthcare Services Are you passionate about delivering exceptional customer service and building meaningful relationships? 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. By adhering to compliance guidelines and embodying our company values, your objective is to deliver extraordinary service while building trust and rapport with current and prospective members. What You'll Be Doing: • Customer Interactions: • 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. • Quality Service: • 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. • Problem Resolution: • Analyze and evaluate customer issues to initiate and coordinate service recovery measures. • Document all member interactions meticulously following established procedures. • Healthcare Knowledge: • 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. • Operational Excellence: • 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. • Performance Metrics: • Monitor and achieve Contact Center KPIs, including call handling, first call resolution, and member retention. • Compliance and Ethics: • 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. • Tools and Systems: • Use multiple systems/screens while assisting callers effectively. • Navigate CRM, EMR/EHR, and ticketing platforms effectively. What You Bring: • Experience: • 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). • Education: • High School Diploma or GED required. • Skills: • Outstanding written and verbal communication skills. • Proven analytical and problem-solving abilities. • Ability to respond concisely and clearly to customer queries. • Strong critical thinking and problem-solving skills. • Typing speed of at least 35 WPM with a 5% or lower error rate. Success Factors for Working from Home • Private Workspace: A dedicated, quiet workspace with a door that closes, free from ambient noise. • Ergonomics: A comfortable desk and chair setup that allows for the proper installation of necessary equipment. • Reliable Internet Connection: Stable, high-speed internet with a minimum bandwidth of 20 Mbps downstream and 20 Mbps upstream. • Quiet, Distraction-Free Workspace: A dedicated, quiet area where you can focus on delivering excellent customer service without interruptions. • Tech-Savvy: Comfort with technology and ability to learn new systems quickly. • Self-motivation & Independence: Ability to stay productive and manage your time effectively in a remote environment. • Communication Skills: Strong verbal and written communication skills, especially in a virtual setting. • Adaptability: Ability to adapt to changing technologies and procedures while working remotely. What You Will Get: • Competitive Pay: Enjoy a competitive hourly rate with opportunities for performance-based increases. • Comprehensive Benefits: Full health insurance coverage, including medical, dental, and vision plans. • Work Environment: A supportive, engaging, and inclusive work environment with opportunities to grow and develop your skills. • Career Growth: Abundant advancement opportunities within the organization. • Inclusive Workplace: We are an Equal Opportunity Employer, welcoming individuals with disabilities and veterans. • Unique Perks: • Cell Phone Benefits: $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. Join Our Team: If you are motivated to make a meaningful impact in the lives of others, we want to hear from you. Apply today to embark on a rewarding career where your skills and dedication will help shape the future of healthcare services. If you like wild growth and working with happy, enthusiastic over-achievers, you'll enjoy your career with us!
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Job Summary and Responsibilities This position has the option to work remote after a 4-week minimum onsite training at the Edmonds Call Center in Edmonds, WA. The Call Center hours are Monday - Saturday 7:00am - 6:00pm and candidates must be available during these hours. • Represents VMMC during initial phone contact by providing patients with appointments, information and other operation support services. • Provides a high level of customer service in a manner consistent with VMMC's mission, goals and service standards. • Answers incoming requests and assists patients based on their needs. Schedules, cancels and reschedules patient appointments by assessing caller's specific needs through probing questions while maintaining patient confidentiality and simultaneously providing each caller with extraordinary and efficient customer service. • Communicates efficiently and effectively with the clinical care team, written or verbally, on behalf of the patient. "We deliver inspired people to do meaningful work." Job Requirements • 6 months of office and/or call center, customer service or healthcare experience • Familiarity with medical terminology and proficient in Microsoft Office products • Previous call center or health care or customer service experience preferred • Proven excellent customer service, communication, verbal and written skills with an emphasis on organization and attention to detail • Ability to problem solve and multi-task; keep confidences; knowledge of scheduling parameters, insurance concepts and patient registration software • Knowledge of VMMC system and providers is necessary to efficiently schedule appointments and answer questions • Ability to meet and exceed service components of this position; knowledge of how to handle calls that are emergent in nature • Proven computer skills (accessing and navigation of websites with the ability to copy and paste information and basic keyboarding) • Demonstrated basic telephone skills (transfer, conference, placing a patient on hold) • Excel in a team based environment with a positive attitude; comfortable with ambiguity and the ability to be flexible We are an equal opportunity/affirmative action employer. Where You'll Work Virginia Mason Franciscan Health brings together two award-winning health systems in Washington state CHI Franciscan and Virginia Mason. As one integrated health system with the most patient access points in western Washington, our team includes 18,000 staff and nearly 5,000 employed physicians and affiliated providers. At Virginia Mason Franciscan Health, you will find the safest and highest quality of care provided by our expert, compassionate medical care team at 11 hospitals and nearly 300 sites throughout the greater Puget Sound region. While you're busy impacting the healthcare industry, we'll take care of you with benefits that include: • Health/dental/vision • FSA and HSA spending accounts • 2 retirement plans • Paid vacation and sick time • Adoption assistance • Wellness program Just as Virginia Mason is dedicated to improving the lives of our patients and our community, we are equally dedicated to your professional and personal success. With a wide range of perks that includes a comprehensive compensation and benefits package, and the opportunity to live in one of the most livable cities in the nation, you will find that an opportunity with Team Medicine is one worth taking.
Utilization Management Nurse
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