Medical Contact Center Representative, Inside Sales

Guide Healthcare

Customer Guide Engagement Specialist serving healthcare members and providers by providing service through various communication channels. Navigating healthcare benefits and care management issues effectively.

Posted 7/24/2026full-timeRemote • Connecticut • 🇺🇸 United StatesJuniorMid-Level💰 $20 - $22 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates exceptional customer service skills with a focus on empathy, active listening, and clear communication. Proficient in navigating healthcare processes and systems while ensuring compliance with HIPAA and protecting personal health information.

Highest-signal resume keywords

Customer Service Experience in HealthcareActive Listening SkillsEmpathy and Rapport BuildingKnowledge of Medical TerminologyProficiency with CRM Software

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Customer ServiceHealthcare Benefits KnowledgeProblem-SolvingCritical ThinkingOutbound CallingEnrollment OutreachDocumentation SkillsCommunication SkillsObjection HandlingMicrosoft Office Suite

Soft Skills

EmpathyPatienceResilienceProfessional AttitudeTeam Collaboration

Tools & Technologies

CRM SoftwareDialer-Based Workflows

Industry Keywords

HIPAA CompliancePersonal Health Information (PHI)Health PlanHMOTPATelemarketingAppointment SettingInside SalesCare ManagementHealthcare Contact Center

Tech Stack

Tools & technologies

About the role

Key responsibilities & impact

Provide friendly, accurate, and timely service to Customers (members/patients, providers, and other stakeholders) through inbound and outbound interactions via phone, email, chat, SMS, video calls, co-browser sessions, and other communication channels.
Actively listen to understand Customers’ needs and concerns and demonstrate empathy and patience.
Help Customers navigate internal processes and available resources to achieve their desired results.
Build rapport and establish trust with Customers to create a positive, personalized experience.
Go above and beyond to exceed Customer expectations and leave a lasting positive impression.
Protect Customers’ privacy, dignity, and Personal Health Information (PHI) at all times and comply with HIPAA and all applicable laws and regulations.
Backup and support other departments (i.e., Claims, UM, Intake, Quality, Care Management, Patient Engagement) and perform a variety of other duties as assigned.
Answer inquiries regarding benefits, claims, eligibility, provider networks, prior authorizations, preventative health promotion, and other healthcare-related topics.
Research and resolve complex issues, collaborating with other departments as needed (e.g., Claims, Provider Relations, Utilization Management, Intake, Care Management, Quality, etc.).
Take ownership of Customer issues, following through to ensure complete resolution and satisfaction.
Proactively identify and escalate recurring issues or trends to management.
Document all interactions and resolutions accurately and thoroughly in the appropriate systems.
Educate Customers on plan benefits, policies, and procedures.
Clearly and concisely explain complex healthcare information in a way that is easy to understand.
Conduct outbound enrollment outreach, inviting eligible members/patients to join Guidehealth’s care management and care coordination programs.
Handle inbound calls from prospective enrollees inquiring about Guidehealth’s care management programs, qualifying interest and guiding them through next steps.
Clearly articulate the value, features, and benefits of our programs in plain, customer-centered language, helping Customers understand how participation supports their health goals.

Requirements

What you’ll need

High school diploma or equivalent required.
Minimum of 2 years of experience in one or more of the following: customer service in a health plan, HMO, TPA, or healthcare setting; OR program enrollment, telemarketing, cold calling, appointment setting, inside sales, or other outbound calling roles.
Candidates with experience in both inbound and outbound Customer service via multiple channels are strongly preferred.
Minimum of 1 year of experience in a healthcare contact center or outbound calling environment.
Exceptional, demonstrated customer service skills, with a genuine passion for helping others.
Strong empathy, patience, and the ability to build rapport with diverse individuals.
Excellent verbal and written communication skills, excellent grammar, and pronunciation in the English language.
Ability to communicate clearly, concisely, and professionally.
Active listening skills and the ability to understand and address customer needs effectively.
Strong persuasion and objection-handling skills, with the ability to articulate the value of programs and services in a clear, Customer-centered way (note: this role does not involve closing sales transactions or collecting payment).
Comfort with structured outbound calling, scripted call flows, and dialer-based workflows.
Resilience and a positive, professional attitude when navigating refusals, voicemails, unanswered calls, and repetitive dialing volume.
Strong problem-solving and critical-thinking abilities.
Ability to navigate complex systems and processes.
Proficiency with computer systems, including CRM software and Microsoft Office Suite.
Ability to learn and retain information quickly.
Ability to work independently and as part of a team; must possess a high level of accountability for your work and in support of the team and the business.
Ability to handle stressful situations with professionalism and composure.
Knowledge of medical terminology, healthcare benefits, and insurance processes.

Benefits

Comp & perks

Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
Have Peace of Mind: We provide Life and Disability insurance for those 'just in case' moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
Support Your New Family: Guidehealth offers paid parental leave to give you the time you need.
Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.