Call Center Customer Service Representative

Where compassion meets innovation and technology and our employees are family.

Thank you for your interest in joining our team! Please review the job information below.

Call Center Customer Service Representative

$3,500 Sign-On Bonus Offered!

Work Schedule: Monday–Friday, 8:00am–4:30pm or 8:30am–5:00pm | Onsite

Join the Driscoll Health Plan Call Center team!

The Driscoll Health Plan is a Medicaid Managed Care organization dedicated to helping members access the healthcare services and resources they need.

We are seeking a friendly, dependable, and detail-oriented Call Center Customer Service Representative to assist our members and healthcare providers with questions regarding health insurance benefits, eligibility, claims, authorizations, crises calls, abuse, fraud, and other healthcare-related needs.

This is a fast-paced, phone-based position that requires excellent communication skills, patience, problem-solving abilities, and a commitment to providing exceptional customer service.

Key Responsibilities

• Meet established call center performance expectations, including spending approximately 90% of scheduled time handling phone calls, based on business needs.
• Answer incoming calls from Driscoll Health Plan members and healthcare providers in a professional, courteous, and timely manner.
• Assist callers with questions regarding Medicaid benefits, eligibility, claims, authorizations, pharmacy benefits, transportation, provider information, and other healthcare services.
• Provide accurate information and work toward resolving questions or concerns during the first call whenever possible.
• Navigate multiple computer systems to research information, document interactions, and resolve customer inquiries.
• Maintain accurate and detailed documentation of calls, inquiries, and resolutions.
• Assist members with locating healthcare providers, scheduling appointments, and navigating the Driscoll Health Plan website.
• Handle sensitive or complex situations with patience, professionalism, and empathy.
• Collaborate with internal departments to resolve issues and escalate concerns when necessary.
• Maintain confidentiality and comply with HIPAA regulations, organizational policies, and regulatory requirements.

Qualifications & Skills

• High school diploma or equivalent required.
• Minimum of 6 months of experience in a call center or healthcare-related field required.
• Strong customer service skills with excellent telephone etiquette and professionalism.
• Excellent verbal and written communication skills.
• Ability to type at least 35 words per minute.
• Strong attention to detail, organizational skills, and problem-solving abilities.
• Ability to multitask and navigate multiple computer applications while assisting callers.
• Comfortable working in a fast-paced, high-volume call center environment.
• Proficiency in Microsoft Office applications, including Outlook, Word, and Teams.
• Previous experience with Medicaid, health insurance, managed care, or medical terminology preferred.
• Familiarity with call center performance metrics and goals preferred.