This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

We are seeking a dependable and service focused Call Center Customer Service Representative to support Montana Medicaid members in a remote call center environment. In this role, you will assist members with questions related to eligibility, benefits, provider changes, and general Medicaid program inquiries. This position offers an excellent opportunity for individuals interested in developing experience within healthcare services, Medicaid programs, and medical claims processes. The ideal candidate will demonstrate strong communication skills, attention to detail, and the ability to navigate multiple computer systems while providing exceptional member support.

Key Responsibilities

• Respond to inbound member inquiries using a computerized call center system.
• Follow established scripts, procedures, and documentation protocols when assisting callers.
• Gather and verify information to accurately assess member needs.
• Research and resolve questions related to Medicaid eligibility, benefits, and claims processes.
• Assist members with provider changes and passport provider updates when applicable.
• Provide clear, accurate, and concise information to members regarding their coverage and available services.
• Document all calls and interactions in the appropriate system according to established guidelines.
• Follow all call handling procedures, escalation processes, and service standards.
• Act as an advocate for Medicaid members to ensure their needs are addressed and resolved.

Qualifications

• Positive and energetic attitude with strong customer service orientation.
• Clear and confident verbal communication skills.
• Strong multitasking ability in a fast-paced call center environment.
• Effective time management and organizational skills.
• High level of attention to detail, including grammar and spelling accuracy.
• Ability to navigate multiple computer systems and maintain accurate documentation.

Requirements

• High School Diploma or GED required.
• Minimum one year of experience in medical insurance, healthcare administration, or a medical office environment.
• Previous call center or professional office experience preferred.
• Experience with data entry, computer systems, and database documentation.

Ideal Candidate Profile

The ideal candidate is empathetic, patient focused, and capable of guiding members through healthcare related questions with professionalism and clarity. Individuals who thrive in structured environments, enjoy problem solving, and take pride in helping others will be well suited for this role.

Benefits

• Medical, dental, and vision coverage.
• Life and disability insurance.
• Additional voluntary benefits.