Medicaid Member Service Representative - Remote

Medicaid Member Service Representative - Remote

North Carolina, North Carolina, United States

CEF Solutions Inc. is hiring Medicaid Member Service Representatives to work from home.
Position overview:

• Hourly rate of pay: $14/hr training; $16.50/hr. after 1 week of production
• Length of Training: 4 weeks training, 2 weeks nesting
• Project duration:
  Steady State - This project operates without a predetermined end date, and it is based on agent performance and the clients needs
• Hours of Operation (HOOPs):
  Mon–Fri; 9:00 AM – 9:30 PM Eastern
• An assigned schedule between the hours of operation
• 40 hours per week
• 8 hours per day + 30 min lunch
• Scheduled 5 days a week

Medicaid Member Service Representatives will primarily handle inbound calls, with occasional outbound outreach as needed. During periods of low call volume, representatives may be assigned small projects, asked to review updated knowledge base articles, or review quality assurance feedback. This is a fully remote role - train from home and work from home.

• Handle a minimum of 50 calls per day, providing exceptional customer service to members, providers, and other stakeholders
• Assist with a variety of inquiries, concerns, requests, and complaints in a professional and tactful manner
• Educate members on plan procedures, benefits, and services, maintaining a calm and helpful demeanor even when dealing with complaints
• Maintain a "willing to assist" attitude and ensure consistent quality service throughout the workday
• Meet and exceed call center metrics, including call volume, quality scores, schedule adherence and NPS

• Minimum of one year of experience in healthcare or health plan settings
• Minimum of one year of customer service and/or call center experience
• High school diploma or equivalent
• Strong commitment to providing high-quality customer service on every call
• Proficiency with Windows platforms and MS Office Suite (Word, Excel)
• Ability to build and maintain positive and effective relationships with coworkers, clients, members, and providers, even while working remotely
• Excellent verbal and written communication skills
• A quiet, dedicated workspace at home with reliable internet connectivity

• Knowledge of or experience with Medicaid Managed Care