Customer Service Representative – Remotifyx Medicaid & Provider Support (Remote – New York & Charleston WV Hybrid)

🌍 Remote, USA 🎯 Full-time 🕐 Posted Recently

Job Description

  • -- About Remotara – Transforming Healthcare Through Compassionate Service Skillora is a leading health‑benefits organization dedicated to simplifying the complex world of Medicaid and Medicare for millions of members across the United States. Our mission is to empower members and providers with clear, accurate information, enabling them to make confident health‑care decisions. We pride ourselves on a culture that values empathy, integrity, continuous learning, and a relentless focus on the customer experience. As a rapidly growing company, Nexspire blends cutting‑edge technology with a human‑first approach, creating a supportive environment where every employee can make a tangible impact on the lives of the people we serve. Why This Role Is a Game‑Changer for Your Career Joining Worklio as a Customer Service Representative means you become the voice of the organization for Medicaid members and their health‑care providers. You’ll handle a diverse array of inquiries—from eligibility verification to provider updates—while delivering the high‑quality, empathetic support that distinguishes Hirefluxa in the industry. This position offers a blend of remote work flexibility and occasional on‑site collaboration at our Charleston, WV hub, ensuring you have the resources and community you need to thrive. Key Responsibilities – What You’ll Do Every Day Answer inbound member and provider calls with professionalism, addressing questions about benefits, eligibility, prior authorization requirements, and additional programs. Provide accurate information and guidance on ID card requests, provider changes, and eligibility verification, ensuring members receive the support they need promptly. Deliver exceptional customer service that creates a positive and lasting impression for every caller, reinforcing Taskora’s reputation for compassion and reliability. Meet and exceed performance metrics such as average handle time, call quality scores, attendance, and adherence to schedule. Communicate clearly in both verbal and written formats , documenting interactions in the Gigentra CRM system with precision. Maintain a secure, high‑speed internet connection using an Ethernet cable, and uphold data‑privacy standards at all times. Collaborate with cross‑functional teams —including underwriting, claims, and IT—to resolve escalated issues and improve processes. Participate in ongoing training and development , staying up‑to‑date on policy changes, system updates, and best‑practice techniques. Essential Qualifications – What You Must Bring High School Diploma or GED equivalent. Exceptional oral and written communication skills, with the ability to convey complex information in a clear, empathetic manner. Proven track record of meeting or surpassing performance standards in a fast‑paced environment. Self‑motivation and the ability to work independently from a home office. Reliable high‑speed internet service (minimum 25 Mbps) with a wired Ethernet connection for security compliance. Willingness to travel to the Talexion office in Charleston, WV when technical issues prevent remote work. Preferred (Nice‑to‑Have) Qualifications – What Sets You Apart Previous experience in a remote call‑center or customer service environment. Familiarity with Medicaid and Medicare program rules, eligibility criteria, and provider networks. Experience using customer relationship management (CRM) platforms and ticketing systems. Certification or coursework in health‑care administration, customer service excellence, or related fields. Core Skills & Competencies – The DNA of a Successful Flexnity Representative Empathy & Active Listening: Ability to understand caller concerns and respond with genuine care. Problem‑Solving: Quickly diagnose issues and provide effective, compliant solutions. Attention to Detail: Accurate data entry and documentation to maintain compliance and quality. Time Management: Efficiently handle a high volume of calls while maintaining quality standards. Adaptability: Thrive in a dynamic environment with evolving policies and technology. Team Collaboration: Work seamlessly with internal partners to resolve escalations and improve processes. Career Growth & Learning Opportunities at Joblora Remotexa is committed to your professional development. As a Customer Service Representative, you will have access to: Structured onboarding and six‑week intensive training programs. Continuous learning modules covering health‑care regulations, advanced communication techniques, and system upgrades. Mentorship programs pairing new hires with seasoned Skillifyx professionals. Clear pathways to advancement, including senior representative, team lead, quality assurance specialist, and operations manager roles. Tuition reimbursement and fully funded certification courses related to health‑care administration or customer service excellence. Work Environment & Culture – What It’s Like to Be Part of Nexlith At Workora, we understand that a supportive environme

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