Call Center Representative - Healthcare - Remote | Wfh

We are currently seeking an experienced and talented individual for a Subrogation Call Center Representative role. As a Subrogation Call Center Representative, you will be responsible for handling all casualty or estate calls involving several state Medicaid beneficiaries or deceased Medicaid beneficiaries. This includes calls from attorneys, paralegals, insurance agents, Medicaid members, and their families.
In this position, you will be responsible for reviewing and updating a variety of cases with current and accurate case notes. You will be expected to provide case status updates while speaking with multiple parties, including attorneys and members, regarding their case history, current status, and next steps. Additionally, you will be responsible for conducting all case document review and updates while speaking with the member or attorney as needed.
To be successful in this role, you will need to maintain a daily system of providing timely and accurate information required to move cases through the case management workflow. You will be expected to interact professionally with a wide range of individuals, including attorneys, insurance adjusters, medical providers, court staff, recipients, family members, and clients.
Your responsibilities will include performing basic and advanced levels of document review to identify current case status and case management, ensuring case progress through workflow, and meeting department objective standards for Customer Service. You will be expected to verify and adhere to HIPAA standards while speaking with members and attorneys on the phone, and ensure all processes meet HIPAA and Government security requirements with regards to sharing/storage/PHI (Personal Health Information).
In addition, you will be responsible for opening new cases and updating all current case information. You may also have additional responsibilities as needed to assist with case intake and verification process tasks. As part of your duties, you may have some training responsibilities limited to projects and specific tasks.
We are looking for a candidate who can interface with all levels of people both internally and externally in a professional manner. You must be able to communicate and comprehend well both verbally and in writing, fluently in English. The ideal candidate will also be able to be careful and thorough about detail including with cite-checking and proofreading skills. You must be able to multi-task and prioritize effectively and work proficiently with Microsoft Office, Word, and Excel.
You should be able to work independently to meet objectives, analyze information and use logic to address work-related issues and problems, and perform oral presentations with good quality. You must be able to perform well in a team environment to achieve business goals and maintain a high level of confidentiality and ethics. This role requires the ability to function effectively under pressure and manage deadline-oriented project demands and multiple initiatives. Additionally, you must be able to sit for long periods of time and perform physical tasks such as lifting, bending, pushing, pulling, stopping, kneeling, reaching, and carrying of light to heavy items (40 to 50lbs).
The minimum education required for this role is a high school diploma or GED, with an associate's degree preferred. You must have at least one year of experience working in a professional office environment, with experience working in a call center preferred. Experience in the insurance industry (casualty or health insurance) is a plus, and knowledge of Microsoft Word and Excel is required. Medicaid and/or Medicare knowledge is also preferred. Being bilingual (Spanish & English) is a plus.
This is a full-time position, and the salary range is $11.12 - $15.00 per hour. We offer health insurance benefits and require weekend availability. This is a remote position, and nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.
We look forward to hearing from you and potentially welcoming you to our team!