Customer Service Representative

Customer Service Representative

BCforward is currently seeking a highly motivated Customer Service Representative for an opportunity- Remote.

Position Title: Customer Service Representative

Location: Remote

Anticipated Start Date: 12/01/2025

Please note this is the target date and it is subject to change. BCforward will send official notice ahead of a confirmed start date.

Expected Duration: 3 months contract with strong possibility of extension

Job Type: [FULL TIME (>%3D40 HRS WEEKLY) [CONTRACT], [REMOTE]

Pay Range: $22/hr. - $23.29/hr.

Please note that actual compensation may vary within this range due to factors such as location, experience, and job responsibilities, and does not encompass additional non-standard compensation (e.g., benefits, paid time off, per diem, etc.).

Job Description:

• Provide frontline support to Medicaid members by addressing questions related to eligibility, benefits, coverage details, claims status, and provider networks.
• Assist members with enrollment, plan changes, and annual renewals, ensuring all required documentation is collected and submitted accurately.
• Manage inbound calls from members, providers, and caregivers, delivering clear explanations of Medicaid guidelines and available plan options.
• Research and resolve routine to moderately complex issues involving billing discrepancies, denied claims, referrals, and prior authorizations by collaborating with internal teams.
• Maintain accurate and detailed documentation of all interactions, actions taken, and follow-up needed in the customer service system.
• Educate members on preventive services, available care resources, and how to navigate their Medicaid benefits effectively.
• Identify and escalate high-priority or sensitive cases - such as eligibility lapses, urgent medical needs, or care coordination concerns - to the appropriate department.
• Adhere to HIPAA standards and Medicaid program requirements to protect member information and ensure compliance.
• Consistently meet quality metrics, call handling standards, and customer satisfaction goals.
• Participate in outreach activities such as coverage renewal reminders, appointment scheduling assistance, or follow-up calls to improve member engagement.

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:

Inbound Calls, Medicaid

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 247385 when responding to this ad.

---