Provider, Member Call Center Agent

Gainwell Technologies

Provider/Member Call Center Agent assisting with healthcare eligibility and benefits inquiries. Responding to calls and documentation using CRM system in a virtual setting.

Posted 7/29/2026full-timeRemote • California • 🇺🇸 United StatesJuniorMid-Level💰 $35,900 - $51,300 per yearWebsite

Core Competencies

Role fit

Core Competencies

Use this summary to align your resume positioning with the role.

Demonstrates strong customer service skills through effective communication and problem-solving while managing inquiries and documentation in a CRM system. Proficient in handling telephone technology and help desk software to support member and provider interactions.

Highest-signal resume keywords

Customer Service ExperienceCRM Ticketing SolutionHelp Desk SoftwareTelephone TechnologyOrganizational Functions

ATS Keywords

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Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills

Customer ServiceCall HandlingInquiry ResolutionDocumentation ManagementResearch Skills

Soft Skills

CommunicationInterpersonal SkillsProblem-Solving

Tools & Technologies

CRM SoftwareHelp Desk SoftwareTelephone SystemsFax Machines

Certifications & Qualifications

High School DiplomaG.E.D.

Industry Keywords

Service Level AgreementsMember InquiriesProvider QuestionsOutbound Calls

About the role

Key responsibilities & impact

Answers telephone calls using an automated system and responds to basic to moderately complex member and provider questions and/or forwards calls to appropriate personnel.
Research provider and member calls/inquiries and responds to appropriate parties in accordance with service level agreements (SLAs).
Records calls in a customer relationship management (CRM) ticketing solution, resolves written member requests/inquiries and updates member history with results of inquiry to include proper documentation.
Interfaces with team personnel, management, and customers in reference to customer service issues.
Conducts outbound calls to members in response to voicemail inquiries, customer direction, or other business needs.

Requirements

What you’ll need

High school diploma or G.E.D.
Two to three years of customer service or other telephone experience
Experience working with organizational functions and personnel
Experience working with fax machines, computer software, and telephone technology
Experience working with and skilled in the use of help desk software

Benefits

Comp & perks

generous, flexible vacation policy
401(k) employer match
comprehensive health benefits
educational assistance
leadership and technical development academies