Conduct administrative intake and scripted clinical intake of calls, providing quality customer service to providers and staff.
Collect and enter confidential information with high confidentiality, maintaining high-quality documentation standards.
Meet key performance indicators like Average Talk Time and quality, while adhering to HIPAA and regulatory standards.
WNS, part of Capgemini, is an Agentic AI-powered leader in intelligent operations and transformation, serving over 700 clients across 10 industries. With operations in 13 countries and more than 66,000 employees, WNS combines scale, expertise, and execution to create meaningful, measurable impact.
Perform quality assurance monitoring for all departments within the call center, including Operations, Enrollments, Customer Success, and Settlements Teams.
Evaluate customer interactions across phone, social media, email, and chat, and develop metrics for excellence to measure performance.
Create and track accurate, timely quality-monitoring reports, and communicate detailed feedback to all teams.
Above Lending is a next-generation financial services company that provides customized lending solutions to help everyday Americans break the cycle of high-cost debt and achieve financial well-being. The company is growing quickly and fosters a culture grounded in compliance, ethics, and technology built around the people it serves.
Mentor and support the quality assurance team to enhance skills and drive motivation.
Evaluate calls to ensure adherence to scripts, SOPs, and compliance regulations.
Generate reports on call quality scores and provide data-driven insights to management.
Natera is a global leader in cell-free DNA testing, dedicated to oncology, women's health, and organ health. The team consists of highly dedicated professionals from world-class institutions who care deeply about their work and each other.
Make high-volume outbound calls to members to verify and gather information from health plan referrals.
Accurately document member interactions and update records in the system before case assignment.
Collaborate with the Client Services team to ensure smooth handoff and thorough information transfer.
We are a client services team focused on member outreach for health plans. Our team is detail-oriented and process-driven, with a commitment to accuracy and professionalism.
Performs clinical quality assurance review of daily clinical validation reviews and communicates differing audit decisions to ensure accuracy.
Integrates healthcare auditing principles and uses industry knowledge to substantiate decisions, reviewing medical records and applying clinical criteria.
Serves as a mentor to other QA auditors and may flex into initial audit or appeals roles as needed.
Cotiviti provides healthcare auditing and recovery solutions to ensure high quality recoverable claims. As a company, it employs a sizable workforce and fosters a culture of compliance, accuracy, and continuous improvement through professional skepticism and mentorship.
Create a welcoming experience by authentically engaging every caller and providing a world-class experience.
Thoroughly and accurately answer questions about customers' healthcare accounts and provide appropriate solutions.
Handle 35-50+ inbound and outbound phone calls per day and work closely with claim staff to adjust claims.
Point C Health is a national third-party administrator that delivers customized self-funded benefit programs. They are a mission-driven company with a focus on partnership, innovation, and a supportive culture.
Drive cross-functional collaboration and track progress using project management tools to ensure on-time delivery of objectives.
Conduct audits of call and email communications to assess quality and accuracy, compiling feedback summaries for management.
Support patient-focused teams with quality improvement initiatives and maintain documentation such as SOPs and protocols.
Natera is a global leader in cell-free DNA testing for oncology, women's health, and organ health. The team consists of highly dedicated statisticians, geneticists, doctors, and other professionals from world-class institutions, fostering a culture of hard work and growth.
Make outbound calls to hospitals and clinics to conduct brief surveys on after-hours and emergency protocols.
Accurately document responses using provided systems while maintaining a professional demeanor.
Handle a high volume of calls, meeting quality standards and protecting confidential information.
Five Star Solutions provides outsourced customer service and survey services for healthcare clients. They are a growing company focused on remote work, offering a supportive environment with paid training and benefits.
Answer inbound calls from Medicare Advantage members and providers with empathy and professionalism.
Handle inquiries regarding benefit eligibility, enrollment, and claims status while conducting thorough research.
Navigate multiple systems to resolve issues and advocate for members, ensuring first-call resolution.
Johns Hopkins Health Plan provides health insurance services to members. It is part of the Johns Hopkins Health System, a large organization with a diverse team of healthcare professionals.
Handle complex customer inquiries and oversee call center operations, including monitoring performance and resolving issues.
Train, mentor, and supervise a team of customer service professionals to ensure growth and optimize performance.
Collaborate with other departments to improve processes and enhance the customer experience, while ensuring compliance with policies.
Judi Health is a health technology company that provides benefit administration solutions to employers and health plans, using a Unified Claims Processing architecture to consolidate pharmacy and medical benefits. They are deploying infrastructure to power healthcare for millions of Americans, with a focus on operational efficiency and transparency.
Takes incoming calls from members and navigates tools to resolve inquiries.
Maintains high service levels and meets performance targets.
Participates in training to develop product knowledge and skills.
Velera is a premier payments credit union service organization and integrated fintech solutions provider serving over 4,000 financial institutions. The company fosters a people-helping-people culture with a remote-first, inclusive environment.
Proactively place outbound calls and handle inbound calls to uncover homeowner project needs and match them with pros.
Participate in pilots, tests, and process improvements to shape new tools and workflows.
Collaborate with the team and meet performance metrics like conversion rate and customer satisfaction.
Angi powers the home services industry by connecting homeowners with skilled pros. With 9 brands in 8 countries and over 300 million projects completed, they foster a collaborative and innovative culture.
Handle inbound calls with professionalism, resolving issues and answering inquiries.
Troubleshoot technical problems and document interactions accurately.
Upsell products and services while maintaining a positive customer experience.
MCI is a tech-enabled business services company delivering Customer Experience, BPO, and cloud solutions across industries like healthcare, retail, and finance. With over 10,000 employees, we foster a culture of growth, learning, and diversity.
Handle incoming calls and answer routine to complex questions from members and providers.
Investigate member inquiries and provide timely responses within SLAs.
Document customer interactions in CRM and maintain accurate records.
Qualfon is a global provider of omnichannel customer experience and business support solutions. They strive to help people pursue their total vocation by creating job opportunities and fostering a supportive, purpose-driven team.
Conduct a high volume of outbound calls, including cold calls, to medical offices and healthcare facilities.
Research medical facilities and use creative problem-solving to identify additional sources when information is hard to find.
Accurately document outreach, findings, and case-related information in internal systems and prepare professional email communications.
Magna Legal Services is a trusted nationwide partner to law firms, corporations, insurance carriers, and government agencies, delivering comprehensive legal support at every stage of a case. The company fosters a culture where talented people can do meaningful work and grow their careers.
Manage high-volume inbound client communications across phone, chat, email, and social media with a focus on first-call resolution.
Handle membership adjustments, policy enforcement, and real-time support for booking and studio inquiries.
Identify opportunities for improvement and deliver elevated client experiences in a fast-paced environment.
Solidcore is a national boutique fitness company offering 50-minute low-impact, high-intensity strength training classes. With over 100 studios across the country, they are committed to diversity, equity, and inclusion in a supportive and empowering culture.
Act as a Gentiva representative helping patients navigate post-acute care, Medicare, billing, and healthcare resources.
Handle non-clinical inbound calls, escalate to nurses when needed, and assist in the admissions process.
Maintain awareness of performance objectives, ensure patient satisfaction, and adhere to company policies.
Gentiva provides compassionate in-home care including hospice, palliative, home health, and advanced illness management. It operates nearly 600 locations with thousands of clinicians in 38 states, fostering a collaborative and supportive culture.
Schedule, reschedule, and cancel primary and specialty care appointments while correcting booking errors as needed.
Handle inbound and outbound patient calls, supporting timely appointment coordination and one-call resolution.
Verify patient eligibility and update demographic information to support accurate scheduling and access to care.
Support patients receiving care within a military healthcare environment by coordinating appointments and helping maintain timely access to primary and specialty care. Founded in 1984, International SOS operates in more than 90 countries, delivering healthcare, medical assistance, emergency response, and workforce support services worldwide.
Answer inbound patient calls promptly, document in EMR, and route to appropriate departments.
Make outbound calls for scheduling, follow-ups, and targeted campaigns while maintaining HIPAA compliance.
Meet performance metrics like handle rate and SLA adherence while collaborating with clinical teams.
Accompany Health is a primary, behavioral, and social care provider for patients with complex needs, offering at-home and virtual care with 24/7 support. The company is distributed across the US, with a mission-driven, empathetic care team and a startup culture.
Perform daily audits of RCM accounts to ensure accuracy and compliance with policies.
Review documentation, billing records, and account activity to identify errors and process gaps.
Communicate quality issues and provide constructive feedback to staff and department leaders.
Our partner focuses on revenue cycle management services for healthcare organizations. They foster a remote culture centered on accuracy, accountability, and continuous improvement, with a team dedicated to quality and compliance.