Healthcare Call Center Specialist

Description We are looking for a Healthcare Call Center Specialist to join a member services team supporting the health insurance industry in Las Vegas, Nevada. This contract-to-permanent opportunity is ideal for someone who communicates with empathy, stays organized in a fast-paced call center setting, and can guide members and providers through benefit, claims, and network-related questions. In this role, you will handle a high volume of inbound inquiries, research issues thoroughly, and deliver clear, accurate information while helping create a positive service experience.

Responsibilities:

- Manage incoming calls from members, healthcare providers, and other contacts, delivering attentive and timely support.

- Research claim-related questions and make claim updates or adjustments when appropriate and supported by policy.

- Address caller concerns with patience and empathy, identifying needs and offering practical next steps.

- Provide clear guidance on fee schedules, provider network participation, coverage requirements, and related service questions.

- Maintain accurate member and customer records while sharing relevant information with internal teams to support resolution.

- Route inquiries to the appropriate department when requests fall outside the team's scope, while assisting with more complex service issues whenever possible.

- Use internal resources, training materials, and decision-support tools to investigate cases and communicate accurate answers.

- Tailor explanations to the caller's level of understanding, confirm comprehension, and educate customers on available options or required actions.

- Contribute to service quality goals, support department initiatives, and assist with special projects or cross-functional tasks as assigned by leadership. Requirements

- Bilingual fluency in English and Spanish is preferred.

- Previous experience in a high-volume inbound call center or customer service environment is required.

- Working knowledge of claims inquiry processes, claims review activities, complaints, and appeals is preferred.

- Experience in a physician office, clinic, group practice, hospital-based practice, or related healthcare setting is strongly preferred.

- High school diploma is required; additional college coursework or business school training is a plus.

- Basic computer skills and intermediate proficiency with Microsoft Office applications, including Word, Excel, Access, PowerPoint, and Outlook, are expected.

- Strong listening, time management, problem-solving, and communication skills with a dependable, detail-focused work style are required.

- Ability to quickly learn managed care procedures, claims payment guidelines, confidentiality standards, and changing departmental processes is essential.

Talent Match®

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit  for more information.

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