Call Center Representative

This role supports commercial member outreach for care gap closure, ensuring each interaction is service-focused. Experience in healthcare, member services, or provider outreach is strongly preferred.

Call Center Representative


Job Summary

This role supports commercial member outreach for care gap closure, ensuring each interaction is service-focused. The position involves contacting members, educating them on benefits and preventive care, and helping them access needed services while maintaining high standards for accuracy and documentation.

Responsibilities

• Conduct outbound outreach to commercial members to support care gap closure initiatives.
• Establish and maintain positive connections with members to improve overall satisfaction.
• Educate members on health plan benefits and recommended preventive screenings.
• Assist members with scheduling appointments with primary care providers.
• Make reminder calls for upcoming appointments and follow up to offer additional assistance as needed.
• Answer incoming calls and respond to written inquiries from members promptly and accurately within established production and quality standards.
• Coordinate with internal departments to ensure timely and appropriate responses to member inquiries.
• Expedite, research, or escalate complex issues to ensure timely resolution.
• Document all call and contact information accurately and thoroughly across multiple systems.
• Maintain organized, detailed, and grammatically correct documentation for all member interactions.

Requirements

• High school diploma or equivalent.
• Excellent customer service and phone communication skills.
• Proficiency using computers and performing most or all work activities on a computer.
• Strong attention to detail and a high degree of accuracy.
• Proficiency with Microsoft Office applications, including Word, Excel, and Outlook.
• Ability to work with multiple systems simultaneously while handling member inquiries.
• Stable and reliable internet connectivity with the ability to connect via ethernet to required equipment, if applicable.
• Ability to maintain a compliant and professional workspace.
• Strong verbal and written communication skills.

Skills

• Customer service and call center operations.
• Member or customer outreach and engagement.
• Office, clerical, or administrative support experience.
• Proficiency with computers and common business software.
• Medical records or release of information experience (preferred).
• Experience in a medical records department or healthcare-related environment (preferred).
• Clear, professional verbal and written communication.
• Ability to multitask and navigate multiple systems while engaging with members.

Summary Qualification

• Minimum of a high school diploma.
• Background in customer service, call center, or member support roles.
• Experience in healthcare, member services, or provider outreach is strongly preferred.
• Demonstrated ability to manage high call volumes while maintaining quality and accuracy.
• Comfort working in a technology-driven environment with multiple software systems.
• Ability to follow processes, escalate issues appropriately, and meet performance standards.

Wollborg Michelson Recruiting is an Equal Opportunity Employer and prohibits discrimination of any kind. We ensure job offers are made based of one s employment experience, skills, and qualifications, regardless of race, gender, ethnic origin, or any other classification protected by law. All applicants must furnish proper identification to prove their legal right to work in the US upon a job offer. We participate in E-Verify to confirm one s right to work in the US. Wollborg Michelson Recruiting does not provide sponsorship for an employment-based visa status.