Healthcare Call Center Representative

Gainwell Technologies

Remote call center representative supporting Medicaid providers and members for Gainwell Technologies. Handling coverage, claims, benefits, and disputed-claim inquiries by telephone.

Posted 8/23/2026full-timeRemote • Maryland • 🇺🇸 United StatesJunior💰 $35,000 - $50,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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

Demonstrates expertise in providing exceptional customer service within the Medicaid sector, effectively interpreting benefits and policies while ensuring compliance with legal regulations. Proficient in managing claims inquiries and maintaining productivity in a metric-driven environment.

Highest-signal resume keywords

Call Center ExperienceMedicaid KnowledgeService Level Agreement ComplianceMicrosoft Office ProficiencyEffective Communication Skills

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

Claims ResolutionBenefit InterpretationMetric Driven PerformanceAuto Answer System ExperiencePC Information Retrieval

Soft Skills

Time ManagementPunctualityTeam CollaborationIndependence in LearningProfessional Telephone Skills

Tools & Technologies

Multiple MonitorsCall Center Software

Industry Keywords

Healthcare IndustryMedicaidLegal RegulationsContract ComplianceCustomer Service

About the role

Key responsibilities & impact

Provide exceptional customer service by telephone to Medicaid providers and members
Assist with coverage, claims, and benefit-related inquiries
Accurately interpret Medicaid benefits and policy provisions
Research and resolve disputed claims
Ensure timely follow-up to achieve prompt resolution
Answer inbound calls within 30 seconds
Use multiple monitors/screens and systems to service calls
Be a productive member of the team
Comply with contract requirements, business unit rules, and related legal regulations
Maintain time management, attendance, and punctuality

Requirements

What you’ll need

At least one year of call center experience, preferably in healthcare, human services, or Medicaid
Experience working in a metric driven environment
Experience using an auto answer system
Experience working in the Healthcare Industry / Medicaid specifically
Experience meeting Service Level Agreements and contractual obligations
Prior office or clerical experience
Ability to learn and ask questions to be independent
Ability to follow written policies, procedures, and procedural guidelines
Ability to access and retrieve information using a PC
Basic understanding of Microsoft Office products
Ability to work on assignments with limited instructions from leadership
Good written and verbal communication skills, including professional telephone skills
Dedicated home office or private workspace with a door
Availability Monday through Friday, 8:00 AM to 5:00 PM
Punctuality and reliable attendance

Benefits

Comp & perks

Work flexibility
Learning and career development
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Leadership and technical development academies