Medicaid Customer Service Representative - Fortuna BMC

As a Medicaid Customer Service Representative, you will respond to customer inquiries in a call center environment using a computerized system. The role requires you to gather information, assess customer needs, and provide support to Medicaid members or healthcare providers. You will act as an advocate for the clients, enrolling or un-enrolling them from services as needed, and educating them on their rights and benefits. This position demands a customer-focused approach and the ability to handle a fast-paced call center environment while providing excellent support to Medicaid members or providers.

WHAT YOU'LL DO:

• Respond to telephone inquiries and complaints using standard scripts and procedures.
• Gather information, assess customer needs, and research/resolve issues.
• Provide clear and concise updates regarding claims or Medicaid member status.
• Facilitate client enrollment and disenrollment with providers by phone or paperwork.
• Act as an advocate for Medicaid clients or healthcare providers.
• Educate clients on managed care access, rights, and benefits using outreach scripts.
• Monitor voicemail and fax communications and respond accordingly.
• Complete assigned training as required.
• Track daily tasks for quality review.
• Perform other duties as assigned.

WHAT YOU'LL BRING:

• At least one year of experience in medical insurance or a medical office setting is preferred.
• Outgoing, energetic attitude with excellent communication skills.
• Ability to multi-task and analyze new situations to solve problems effectively.
• Capability to remain calm under pressure and manage time efficiently.
• Strong attention to detail, grammar, and spelling accuracy.
• Ability to learn from both successes and mistakes and incorporate new technologies.

Fortuna operates as a staffing agency engaged in sourcing, screening, and presenting potential candidates for employment opportunities on behalf of our clients.

Fortuna was founded in 2012 by practicing professionals with more than 50 combined years of experience. Our headquarters is in McClellan, California with offices in Los Angeles and New York, and satellite offices in the Philippines and Israel. Fortuna is an active member of multiple California service agreements, including the CMAS, ITMSA (Tier 2), CalPERS SpringFed Pool, as well as multiple municipalities and large corporation vendor pools www.gofortuna.com.