Call Center Customer Service Representative (Remote)

Focus Care Inc. is a Boston-based privately owned national healthcare services company with over 25 years of experience supporting Medicare Medicaid and ACA populations. We partner with health plans nationwide to identify and document high-risk conditions improve member health outcomes and support risk adjustment and reimbursement accuracy.

Our national provider network includes LPNs/LVNs RNs and Nurse Practitioners. Since 2008 Focus Care has completed thousands of health evaluations across the country and works closely with health plans to deliver compliant high-quality in-home and provider-based health assessments.

Position Overview

The Member Engagement Sales Representative is responsible for contacting eligible health plan members to educate them on a covered healthcare benefit and schedule in-home or provider-based health assessments.

This role blends customer service education and performance-based scheduling. Success is measured by completed assessments quality interactions data accuracy and compliance with healthcare regulations.

This is not a hard sales role but sales or consultative selling experience is strongly recommended as success requires confidence in guiding conversations overcoming objections and helping members make informed decisions.

Key Responsibilities

• Contact Medicare Medicaid and ACA members via outbound and inbound calls to:
• Explain Focus Cares health assessment services
• Address member questions and concerns
• Schedule in-home or provider-based healthcare appointments
• Accurately document member information/appointment details in Focus Care systems
• Adjust reschedule and confirm appointments as needed to support completion
• Work diligently to meet individual and team productivity quality and completion goals
• Handle a high volume of outbound calls using Focus Cares provided phone systems
• Manage inbound calls and return member voicemails promptly
• Follow approved scripts workflows and talking guidelines to ensure compliance
• Present a professional friendly and reassuring experience to members
• Maintain strict confidentiality and security of protected health information (PHI)
• Report on member complaints or issues immediately through approved channels
• Collaborating with Team Leads and peers to support campaign success
• Participate in training sessions coaching and team meetings
• Assist with operational tasks reporting support and data validation as needed
• Maintain schedule adherence and availability during assigned working hours
• Comply with all company policies security standards and remote monitoring requirements

Performance Expectations

• Representatives are expected to:
• Consistently meet defined productivity and appointment completion targets
• Maintain strong appointment show and completion rates
• Achieve required quality assurance and compliance standards
• Demonstrate accuracy in data entry and documentation
• Maintain reliable attendance and schedule adherence

Performance is measured through a standardized scorecard that evaluates productivity quality compliance and overall contribution to campaign success.

Qualifications

• Desire to work in a fast-paced results-oriented call center environment
• Strong work ethic with the ability to work independently and stay on task
• Friendly conversational communication style with diverse populations
• High level of discretion and commitment to confidentiality
• Ability to comply with a fixed daily work schedule including breaks and lunch
• Ability to receive coaching and constructive feedback
• Strong data entry skills with a focus on accuracy and integrity
• Proficiency with Microsoft Office applications
• Typing speed of approximately 60 words per minute
• Ability to multi-task across multiple systems while maintaining accuracy
• Critical thinking and problem-solving skills
• Interest in contributing to team success and continuous improvement
• Prior call center customer service or healthcare experience preferred (not required)

Job Type: Part-time

Pay: $35.00 - $35.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Paid time off
• Vision insurance

Work Location: Remote