Bilingual InboundOutbound Support Agent

Montgomery, TX - USA

Hourly Salary: USD 16 - 17

Posted on: 30+ days ago

Vacancies: 1 Vacancy

Job Summary

We are seeking a talented individual to join our team in supporting the HIPP/Premium Assistance program. This role involves proactive outreach (both outbound/inbound calls) to current members to collect the required documentation for annual case reviews. The ideal candidate will manage documentation verification coordinate with members and employers and deliver exceptional customer service while ensuring accurate data entry and timely processing. 6 month contract

Worksite: OnSite- Minimal (in-state) as required for training meetings audits

Work Schedule: Monday-Friday 8:00 AM-5:00 PM CST

Compensation: $17.00 Per Hour

What We Offer:

Paid sick leave based on state regulations after 90 days of employment
Medical dental and vision are offered after a waiting period (60% paid by Fortuna)
Free TeleMedicine and Mental Health services for all employees and their families
Additional voluntary benefits: Group Life Insurance Accidental Insurance Critical Care Short Term Disability

What Youll Do

Provide enrollment assistance and guidance to Medicaid-eligible recipients and their families regarding the HIPP / Premium Assistance program via phone or correspondence.
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.
Maintain active case files during open enrollment cycles premium review and payment processing.
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.
Conduct advanced document review legal research or case escalation as needed particularly on more complex cases.
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).
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.

What Youll Bring

At least 2 years of experience in health insurance Medicaid public health programs or government-sponsored programs (or equivalent experience).
At least 2 years of 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 with 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
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

Fortuna operates as a staffing agency that sources screens and presents potential candidates for employment opportunities on behalf of our clients. Founded in 2012 by practicing professionals with more than 50 combined years of experience Fortuna is headquartered 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) and CalPERS SpringFed Pool as well as various municipalities and large corporation vendor pools.

Career Site:

Required Experience:

Unclear Seniority