Call Center Representative (Medicaid Support) - Montgomery, AL

Summary

This position is part of a cross-functional team responsible for handling inbound calls from providers and/or recipients of Alabama Medicaid. Call Center Representatives are responsible for listening to provider and/or recipient needs/issues and providing helpful solutions.

Your role in our mission

This is an important position in Gainwell's commitment to helping clients deliver better health and human services outcomes.

• Provide knowledgeable responses to basic client questions; elevate more complex cases to appropriate staff as needed.
• Put your skills to work to solve client problems, update account history and follow up with clients to confirm their inquiry or request is resolved
• Adhere to the client's SLAs and consistently meet production targets
• Collaborate with team members, management, and clients to resolve client inquiries; cross-train new resources in customer service processes
• Process client inquiries more efficiently and effectively by reviewing and recommending changes to procedures and workflow
• Update address information, verify benefit limits. This is a very high-volume call center.

What we're looking for

• Education: High School Diploma or G.E.D. required.
• Schedule Flexibility: Must be able to work a rotating schedule, including evening shifts, occasional Saturdays, and holidays, to support multiple departments including the Provider Assistance Center, Electronic Media Claims (EMC) Helpdesk, and the Recipient Call Center.
• Call Center Experience: Minimum of 1 year of experience in a call center environment preferred.
• Customer Service: Demonstrated ability to provide high-quality customer service, primarily over the phone, to Medicaid recipients.
• Eligibility & Claims Support: Assist recipients with a range of inquiries related to eligibility and claims payments, providing clear and accurate information.
• Problem Resolution: Identify and resolve common issues, including demographic and provider-related discrepancies that may impact eligibility or claim processing.
• Work Schedule Requirements:  The standard schedule for this role is Monday–Friday from 8:00AM–5:00PM CST. However, due to the operational needs of the EMC Helpdesk and cross-departmental responsibilities, candidates must also be available for the following rotating shifts:
  • Rotating Weekday Shift: Monday–Friday, 11:30AM–8:00PM CST
  • Rotating Saturday Shift: 4-hour shifts, either 9:00AM–1:00PM CST or 1:00PM–5:00PM CST
  • Rotating Holiday Shift: May include one of the following schedules: 7:00AM–1:00PM CST, 8:00AM–5:00PM CST, or 11:30AM–8:00PM CST
• Remote Work Flexibility: Saturday and holiday shifts may be worked remotely, providing employees with additional flexibility and work-life balance.

Please note: Employees do not consistently work the 11:30AM–8:00PM weekday shift, Saturdays, or holidays. These shifts are scheduled on a rotating basis. When scheduled for a Saturday shift, employees will receive a 4-hour split shift (10:00AM–2:00PM CST) on either Wednesday or Thursday to maintain a 40-hour work week.

What you should expect in this role

• This is a onsite position in Montgomery, AL
• Interviews will be conducted in person at the Montgomery location.
• This position is for a Call Center Representative that will be cross-trained to take calls for both the Provider Assistance Center and the Electronic Media Claims Helpdesk.
  • The Provider Assistance Center operates Monday–Friday, 8:00AM–5:00PM CST.
  • The EMC Helpdesk operates Monday–Friday, 7:00AM–8:00PM CST; Saturdays, 9:00AM–5:00PM CST; and on holidays with the exception of Thanksgiving and Christmas Day.
• As part of the application process for this position, you will be required to complete an assessment in order to proceed further.
• To work effectively as a teleworker or hybrid positions with Gainwell, employees must have a broadband internet connection with a minimum speed of 24 Mbps download and 8 Mbps upload. Higher speeds are recommended for optimal performance.
• To Test your internet download and upload speed:
  • Go to Google.
  • Search for Internet Speed Test or click here.