Call Center Representative

Position Title: Call Center Representative

Location: Montgomery, AL, 36117

Pay Rate: $17/hr to $18.50/hr on W2

Anticipated Start Date: 11/03/2025
Please note this is the target date and is subject to change. BCforward will send official notice ahead of a confirmed start date.

Expected Duration: 5+ Months (contract position)

Job Type: (40+ HOURS WEEKLY], [CONTRACT], [ONSITE]

Job Description:
Position Summary

• The Senior Assistant (Case Management) will support the HIPP / Premium Assistance program by handling case-level operations: verifying insurance coverage, maintaining case files, processing premiums and payments, interacting with recipients and employers, and ensuring program compliance. This role helps ensure that Medicaid pays premiums only when cost-effective and that eligible recipients benefit appropriately.

Key Responsibilities & Duties
Core Case / Member Services
* Provide enrollment assistance and guidance to Medicaid-eligible recipients and their families regarding the HIPP / Premium Assistance program via phone or correspondence. Gainwell Technologies Jobs
* Verify, document, and investigate existing health coverage for Medicaid recipients and their dependents (employer plans, COBRA, etc.). Gainwell Technologies Jobs
* Assist in identifying members who may qualify for HIPP / Premium Assistance. Gainwell Technologies Jobs
* Obtain and verify documents required for eligibility: insurance policies, employment verification, premium invoices, etc. Gainwell Technologies Jobs
* Maintain active case files during open enrollment cycles, premium review, and payment processing. Gainwell Technologies Jobs+1
* Process, review, and follow up on premium payments / reimbursements, ensuring timely and accurate payments, and tracking any discrepancies.
* Perform ongoing case maintenance and audits, updating records for status changes, renewals, terminations, or escalations.
* Complete periodic reporting (e.g. case metrics, enrollment trends, audit reports) as required by state or internal stakeholders.
* Respond to high volumes of inbound and outbound calls and inquiries about eligibility, coverage, program rules, and status. Gainwell Technologies Jobs+1
* Conduct advanced document review, legal research or case escalation as needed, particularly on more complex cases. Gainwell Technologies Jobs+1
* Prioritize case events, manage deadlines, escalate issues to supervisors or subject matter experts when appropriate.
Compliance & Policy
* Ensure strict adherence to HIPAA privacy and security standards when handling protected health information (PHI). Gainwell Technologies Jobs+1
* Follow Medicaid, federal, and Alabama-specific HIPP / premium assistance rules, policies, and procedures.
* Support internal or external audits, submitting documentation and explanations for case decisions.
* Participate in training, quality assurance, and performance improvement programs related to case management operations.
Collaboration & Communication
* Coordinate with state Medicaid agency staff, other Gainwell teams, employers, insurers, and service providers as needed.
* Liaise with internal audit, legal, compliance, and escalation teams to resolve disputes or complicated cases.
* Provide feedback or suggestions to improve processes, workflows, policies, or system tools.

Qualifications & Skills
Minimum / Required
* At least 2 years of experience in health insurance, Medicaid, public health programs, or government-sponsored programs (or equivalent experience).
* At least 2 years call center / phone-based experience (inbound and outbound) making inquiries, responding to recipients.
* Strong customer service, written and verbal communication skills
* Excellent organizational, detail orientation, and ability to work under deadlines
* Ability to analyze data, apply logical reasoning, and make informed decisions
* Proficiency in Microsoft Word, Excel, and familiarity navigating web-based systems or internal tools
* Working knowledge of HIPAA privacy/security and handling of sensitive data
* Ability to handle stress, prioritize competing tasks, and escalate appropriately
* Professional demeanor, interpersonal skills, adaptability

Preferred / Desired
* Experience specifically with HIPP, premium assistance, Medicaid or health insurance programs
* Call center / high-volume case operations experience
* Bilingual (especially in languages common in the region)
* Familiarity with health care / insurance terminology
* Previous experience with auditing, compliance, or fraud waste abuse program work

Work Environment & Conditions
* Location: Onsite in Montgomery, AL (or assigned Alabama office)
* Hours: Standard business hours, Monday-Friday (with possible occasional overtime)
* Travel: Minimal (in-state) as required for training, meetings, audits
* Equipment: Standard office setup (PC, phone, secure access to case management systems)
* Workload: High-volume case handling with performance metrics (turnaround times, accuracy, call volumes)

Benefits:
BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.

Keywords:
Call Center/ Inbound/ Outbound/ Medical/ Healthcare

About BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward's 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.

Interested candidates please send resume in Word format Please reference job code 244851 when responding to this ad.