Customer Service Representative - Provider and Member - Warwick, RI; Hybrid

Call Center Representative
- Healthcare Provider Support
- Hybrid
- Warwick, RI

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary Provide customer service support to Rhode Island Medicaid providers and members by answering claims, eligibility, billing, and benefit questions. Responsibilities include researching policy requirements, resolving calls and follow-ups, performing manual enrollment data entry, supporting claims resolution, and assisting with Provider Enrollment mailings and quality control.

Your role in our mission Answer an estimated 40-50 inbound calls daily from the Rhode Island Medicaid provider network and member beneficiaries. Providing excellent oral communications with quality customer service. Follow through and resolving all calls. Address billing and eligibility questions with your commitment to follow up as necessary to resolve. Create and manage computer call logs/references. Provide excellent customer service to include offering added assistance as appropriate.

This includes becoming familiar with web service offerings in order to direct a provider to these offerings. Train and support peers and new team members

What we're looking for Minimum of a high school diploma or GED. Two or more years of customer service experience in a professional setting. Detail oriented and reliable Good typing and computer skills Excellent verbal communication

What you should expect in this role Hybrid work environment based in Warwick, RI. Standard schedule:
Monday through Friday, 8:30 a.m. – 5:00 p.m. On-site presence required during initial training period before transitioning to hybrid. Structured performance goals with opportunities for development and career growth. Supportive team culture focused on collaboration, learning, and continuous improvement.