Call Center Representative

Conduent State Healthcare, LLC seeks a Call Center Representative to support Medicaid members and providers. In this role, you will handle high-volume inbound calls, respond to questions on eligibility, enrollment, and benefits, and help members navigate program rules and services. You will document interactions accurately, follow HIPAA and compliance standards, and meet quality and productivity goals. The position requires strong communication, basic computer proficiency, attention to detail, and a commitment to delivering compassionate, accurate service to vulnerable populations.

Responsibilities

• Answer high-volume inbound calls from Medicaid members and providers
• Assist with eligibility, enrollment, and coverage questions
• Explain Medicaid benefits, claims status, and program rules clearly
• Document all interactions accurately in call center systems
• Follow scripts, procedures, and HIPAA/privacy requirements
• Escalate complex or urgent issues to supervisors as needed
• Meet performance metrics for quality, handle time, and customer satisfaction
• Collaborate with team members and supervisors to improve service
• Participate in ongoing training on systems, Medicaid policy, and compliance
• Identify and report trends or issues impacting member experience

Required Skills

• Customer service in a call center environment
• Healthcare or Medicaid program knowledge
• Call documentation and CRM systems
• Basic data entry and typing skills
• Knowledge of HIPAA and privacy practices
• Use of call scripts and standard operating procedures
• Multitasking across multiple systems while on calls
• Conflict resolution and de-escalation
• Professional verbal communication
• Basic PC literacy (email, web portals, office tools)