Remote Healthcare Call Center Rep

Job Description

Job Description

Rep II, Operations (Remote)
Pay Rate: $20.28/hour

Location: Remote (Work From Home)

Start Date: September 7

Schedule

• Training: Monday–Friday, 8:00 AM – 4:30 PM CST
• Regular Schedule: Rotating shifts between 7:00 AM – 8:00 PM CST
• Rotating weekends and holidays as required
• Overtime may be required during peak periods

Position Overview

We are seeking a detail-oriented Operations Representative II to support Medicare members, healthcare providers, and prescribers by processing coverage-related requests through both phone and fax channels. This fully remote position combines customer service, case management, and administrative processing while ensuring compliance with Medicare regulations, CMS guidelines, and internal quality standards.

Responsibilities

• Process Medicare coverage requests received through inbound calls, outbound calls, and fax.
• Review, create, document, and resolve member cases accurately and within required CMS timelines.
• Communicate professionally with Medicare members, healthcare providers, and prescribers.
• Perform outbound outreach to obtain missing information or provide case updates.
• Maintain complete and accurate documentation in company systems.
• Research and resolve complex case issues while following established policies and procedures.
• Ensure compliance with Medicare regulations, CMS requirements, HIPAA, and company quality standards.
• Manage multiple systems simultaneously while maintaining productivity and accuracy.
• Meet productivity, quality, and service level expectations in a fast-paced environment.
• Adapt to changing business needs and support both phone and offline processing functions.

Qualifications

• Strong customer service and communication skills.
• Excellent attention to detail and organizational abilities.
• Ability to multitask while navigating multiple computer applications.
• Strong problem-solving and critical-thinking skills.
• Comfortable working independently in a remote environment.
• Ability to maintain confidentiality and comply with HIPAA requirements.
• Reliable attendance and flexibility to work assigned schedules, weekends, holidays, and overtime as needed.

Work From Home Requirements

• Dedicated, quiet, and secure home workspace.
• Reliable high-speed internet connection.
• Must connect directly to company equipment using a hard-wired Ethernet connection.
• Wireless internet connections and mobile hotspots are not permitted.
• Camera must remain on during training, team meetings, and supervisor meetings as part of the onboarding process.

Additional Information

• Full-time remote position.
• Opportunity for permanent employment based on performance.
• Safety Sensitive position.

If you are interested, please reach out to Chin Yang at A-Line Staffing .