Medical Contact Center Representative, Inside Sales

About the role

At Guide Health, we prioritize creating a supportive and positive workplace where our employees can thrive. We are looking for a dedicated Medical Contact Center Representative to join our team, serving as a vital point of contact for our members, patients, and healthcare providers. In this role, you will not only respond to inquiries but also guide customers through the complexities of healthcare benefits and care management. Your primary goal will be to deliver exceptional service, ensuring that every interaction is characterized by empathy, clarity, and efficiency.

Key facts

What you'll do

• Deliver friendly, accurate, and timely assistance to customers through various communication channels, including phone, email, chat, and video calls.
• Actively listen to customers to understand their needs and concerns, demonstrating empathy and patience throughout the interaction.
• Assist customers in navigating internal processes and available resources to achieve their desired outcomes.
• Build rapport and trust with customers to ensure a personalized and positive experience.
• Strive to exceed customer expectations, leaving a lasting positive impression with every interaction.
• Safeguard customers' privacy and comply with HIPAA regulations and all relevant laws regarding Personal Health Information (PHI).
• Provide backup support to other departments, such as Claims and Care Management, and perform additional duties as assigned.
• Address inquiries related to benefits, claims, eligibility, and other healthcare topics, ensuring accurate and timely resolutions.
• Collaborate with various departments to resolve complex issues and take ownership of customer concerns until they are fully resolved.
• Document all customer interactions and resolutions meticulously in the appropriate systems.
• Educate customers on plan benefits, policies, and procedures, simplifying complex healthcare information for better understanding.
• Conduct outbound outreach for program enrollment and wellness check-ins, guiding eligible members through the enrollment process.
• Use consultative listening and persuasion skills to address customer hesitations and encourage participation in care management programs.
• Follow approved scripts and adapt your communication style to suit individual customer needs while maintaining compliance with calling regulations.
• Participate in ongoing training and development to enhance your skills and contribute positively to the team environment.

Requirements

• A high school diploma or equivalent is required.
• At least 2 years of experience in customer service within a healthcare setting, such as a health plan or HMO, or in roles involving program enrollment or telemarketing.
• A minimum of 1 year of experience in a healthcare contact center or outbound calling environment.
• Proven customer service skills with a genuine passion for helping others.
• Strong empathy and the ability to build rapport with a diverse range of individuals.
• Excellent verbal and written communication skills, with a focus on clarity and professionalism.
• Active listening skills to effectively understand and address customer needs.
• Strong persuasion and objection-handling abilities, articulating the value of services in a customer-centered manner.
• Comfort with structured outbound calling and scripted interactions.
• A positive attitude and resilience when dealing with refusals and high call volumes.

Nice to have

• Experience with healthcare software and customer relationship management (CRM) tools.
• Familiarity with HIPAA regulations and healthcare compliance standards.
• Bilingual abilities, particularly in Spanish or another language, are a plus.

Skills & tools

• Proficient in using various communication platforms, including phone systems, email, chat, and video conferencing tools.
• Strong organizational skills and attention to detail for accurate documentation and follow-up.
• Ability to work collaboratively in a fast-paced, team-oriented environment.

Practical notes

• This position is based in Hartford, US, and requires adherence to the company's policies and procedures.
• Employees are encouraged to engage in continuous learning and development opportunities to enhance their skills and career growth.
• The role involves a commitment to maintaining customer confidentiality and protecting sensitive information at all times.

Join Guide Health and be part of a mission-driven team that is dedicated to making a positive impact in the lives of our customers. Your contributions will help empower individuals to navigate their healthcare journeys with confidence and support. If you are passionate about customer service and healthcare, we would love to hear from you!