Experienced Medical Billing and Call Center Representative for Remote Healthcare Customer Service

Join Capgemini, a Global Leader in Consulting and Technology Services, as a Remote Medical Billing and Call Center Representative

Capgemini is a worldwide pioneer in consulting, digital transformation, technology, and engineering services. With a rich heritage spanning over 50 years and a presence in nearly 50 countries, we empower organizations to achieve their business goals through a comprehensive range of services, from strategy to operations. As a multicultural company of 270,000 team members, we are driven by the conviction that the business value of technology is realized through people. With Altran, our combined revenues in 2019 stood at €17 billion.

About This Opportunity

We are seeking an experienced Medical Billing and Call Center Representative to join our team on a remote basis. As a key member of our customer service team, you will be responsible for handling inbound calls from prescribers and members, utilizing multiple software systems to create prescription cases, and determining coverage, determination, and appeals processes. This is an excellent opportunity to leverage your excellent communication skills, problem-solving abilities, and experience in a fast-paced, highly regulated environment.

Key Responsibilities

• Receive inbound phone calls from prescribers and members, providing timely and effective support.
• Utilize multiple software systems to create prescription cases, determine coverage, and manage appeals processes.
• Demonstrate excellent written and verbal communication skills, ensuring seamless interactions with clients.
• Display soft skills while moving calls forward, meeting or exceeding government-mandated timelines.
• Comply with turnaround time, productivity, and quality standards, ensuring high-quality service delivery.
• Convey resolutions to beneficiaries or providers via direct communication and professional correspondence.
• Acquire and maintain basic knowledge of relevant and changing client guidance, staying up-to-date on industry developments.
• Research, troubleshoot, and resolve client application discrepancies using computer systems.
• Meet daily tasks through various forms and mediums of communication – written, verbal, and/or by phone.

Essential Qualifications

To succeed in this role, you will need:

• Prior call center experience, preferably with a multi-screen setup for easier navigation of multiple applications.
• Availability for remote workspace audits (via webcam or phonecam) with an inspection time of less than 5 minutes.
• High-speed and reliable internet connection.
• A quiet and focused work environment.
• The ability to effectively communicate with members and prescribers while managing multiple software systems.
• Accountable and results-driven, with a critical thinking and problem-solving mindset.
• Receptive to constructive feedback and flexible in adapting to change.
• The ability to effectively plan, prioritize, and organize time and workload.
• Proficient in navigation of multiple computer applications, with proficient use of keyboard, mouse, and ability to navigate 2 workstation monitors.
• Able to multi-task efficiently to complete each call within the AHT targets designated by the client.
• Ability to type more than 30 WPM.

Preferred Qualifications

While not mandatory, the following qualifications are highly desirable:

• At least two years of general business experience that includes problem resolution, business writing, quality improvement, and customer service.
• Six months of PBM/pharmaceutical-related work strongly desired.
• 1+ years of call center experience.
• 1+ years of healthcare background.
• Team player with excellent communication skills, both verbal and written.
• Exposure to business domain is an added advantage.
• Organizational skills, including the ability to multi-task, set priorities, and follow up promptly.
• Ability to work a flexible work schedule.

Education

A High School Diploma, GED, or equivalent is required. A Bachelor's degree in a related field or equivalent work experience is preferred.

What We Offer

As a member of our team, you will enjoy a competitive salary of $11/hour, with a 40-hour workweek schedule, ideally from Monday to Friday. This is an 18-month position with benefits, offering a great opportunity for career growth and development. You will be part of a dynamic team, working in a fast-paced, highly regulated environment, with opportunities for learning and professional advancement.

Our Culture and Values

At Capgemini, we are committed to fostering a culture of diversity, equity, and inclusion. We are an Equal Opportunity Employer, encouraging diversity in the workplace, and all qualified applicants will receive consideration for employment without regard to race, national origin, gender identity/expression, age, religion, disability, sexual orientation, genetics, veteran status, marital status, or any other characteristic protected by law.

Take the Next Step

Are you ready for this exciting opportunity? Apply now and let's discuss how you can become a vital part of our success story. If you're a motivated and experienced professional looking for a challenging role in a dynamic environment, we encourage you to submit your resume to [email protected].

Join us in shaping the future of healthcare customer service, and discover a rewarding career with Capgemini. Apply today!