Call Center Customer Service Representative

Where compassion meets innovation and technology and our employees are family.

Call Center Customer Service Representative

$3,500 Sign-On Bonus Offered!

Work Schedule: Monday–Friday, 8:00am–4:30pm or 8:30am–5:00pm | Onsite

Join theDriscoll Health Plan Call Center team!

The Driscoll Health Plan is a Medicaid Managed Care organization dedicated to helping members access the healthcare services and resources they need.

We are seeking a friendly, dependable, and detail-oriented Call Center Customer Service Representative to assist our members and healthcare providers with questions regarding health insurance benefits, eligibility, claims, authorizations, crises calls, abuse, fraud, and other healthcare-related needs.

This is a fast-paced, phone-based position that requires excellent communication skills, patience, problem-solving abilities, and a commitment to providing exceptional customer service.

Key Responsibilities

• Meet established call center performance expectations, including spending approximately 90% of scheduled time handling phone calls, based on business needs.
• Answer incoming calls from Driscoll Health Plan members and healthcare providers in a professional, courteous, and timely manner.
• Assist callers with questions regarding Medicaid benefits, eligibility, claims, authorizations, pharmacy benefits, transportation, provider information, and other healthcare services.
• Provide accurate information and work toward resolving questions or concerns during the first call whenever possible.
• Navigate multiple computer systems to research information, document interactions, and resolve customer inquiries.
• Maintain accurate and detailed documentation of calls, inquiries, and resolutions.
• Assist members with locating healthcare providers, scheduling appointments, and navigating the Driscoll Health Plan website.
• Handle sensitive or complex situations with patience, professionalism, and empathy.
• Collaborate with internal departments to resolve issues and escalate concerns when necessary.
• Maintain confidentiality and comply with HIPAA regulations, organizational policies, and regulatory requirements.

Qualifications & Skills

• High school diploma or equivalent required.
• Minimum of 6 months of experience in a call center or healthcare-related field required.
• Strong customer service skills with excellent telephone etiquette and professionalism.
• Excellent verbal and written communication skills.
• Ability to type at least 35 words per minute.
• Strong attention to detail, organizational skills, and problem-solving abilities.
• Ability to multitask and navigate multiple computer applications while assisting callers.
• Comfortable working in a fast-paced, high-volume call center environment.
• Proficiency in Microsoft Office applications, including Outlook, Word, and Teams.
• Previous experience with Medicaid, health insurance, managed care, or medical terminology preferred.
• Familiarity with call center performance metrics and goals preferred.