Call Center Representative Remote Jobs in Rhode Island (US)
This page tracks remote call center representative openings that are location-eligible for Rhode Island.
This page tracks remote call center representative openings that are location-eligible for Rhode Island.
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• Stand up, develop, and lead a new contact center operation • Oversee daily operations and performance of the team • Manage, coach, and develop staff to meet established performance standards • Monitor key performance indicators and report on operational outcomes • Ensure customer issues are resolved promptly and thoroughly • Drive consistency in service delivery to meet contractual outcomes • Build strong cross-functional relationships across Sharecare • Identify opportunities to expand scope in partnership with leadership and clients • Hire, onboard, and develop a net new frontline team • Develop and implement engagement strategies to drive retention, performance, and team satisfaction • Monitor staff attendance and performance daily • Develop and maintain Standard Operating Procedures • Analyze operational trends and conduct recurrent training as required • Lead operational transitions including technology migrations • Identify and implement process improvements to enhance service efficiency
• Analyzing customer interactions using Verint’s Speech Analytics technology • Identifying behavioral trends, operational inefficiencies, compliance risks, and improvement opportunities • Maintaining categories, keyword libraries, and search queries • Validating findings, identifying root causes, and quantifying business impacts • Creating analytical narratives, incident summaries, and business cases • Utilizing advanced analytical techniques and reporting methodologies • Monitoring call activity near real-time for trends and issues • Presenting findings, observations, and recommendations to leadership
• Serve as the primary administrator for enterprise contact center platforms and communication technologies. • Configure and oversee system settings, user accounts and permissions, routing rules, extension directories, business hour rules, and system integrity checks. • Troubleshoot platform issues and coordinate resolution with internal stakeholders and third-party vendors. • Maintain system documentation and ensure technology configurations align with operational requirements. • Evaluate platform enhancements and recommend improvements to increase efficiency and user experience. • Design, configure, and optimize Interactive Voice Response (IVR) menus and patient self-service experiences. • Manage call routing logic to ensure patients reach the appropriate department, practice, or resource. • Monitor call flow performance and identify opportunities to reduce abandonment rates and improve caller satisfaction. • Test and validate routing changes prior to deployment. • Administer enterprise digital fax systems and workflows. • Manage fax routing, user access, integrations, and troubleshooting activities. • Monitor system performance and ensure reliable delivery and receipt of patient documentation. • Support and administer AI-driven call analytics, speech intelligence, and automated routing technologies. • Develop, maintain, and distribute enterprise call reports and KPI dashboards. • Lead and coordinate technology implementation projects related to contact center operations and patient engagement platforms. • Develop training guides, standard operating procedures, job aids, and technology documentation. • Support contact center operations across multiple practices and geographic regions.
CVS Health is a leading healthcare company operating CVS Specialty, CVS Pharmacy, CVS MinuteClinic, and CVS Caremark. In 2018, CVS combined forces with healthca
Title: Outbound Call Center Rep (Remote) Location: United States Job Description: We're building a world of health around every individual - shaping a more connected, convenient and compassionate health experience. At CVS Health, you'll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger - helping to simplify health care one person, one family and one community at a time. - Starting hourly rate $15.00, with unlimited bi-weekly commission potential. - 10 days of required paid training (Monday-Friday, 8AM-4:30PM CST.) - Call center hours of operation are Monday-Sunday 7AM - 7PM, actual shift will be determined at time of hire. - Competitive benefits, PTO, tuition reimbursement, and more! How will this role have an impact? At Signify Health, we value and seek exceptional thinkers with the heart and humility to match. Join us on a mission to improve lives and make a lasting difference. As a Member Engagement Coordinator you will contact members of various Medicare Advantage and Medicaid health plans by phone to offer, explain, and schedule a free in-home or virtual healthcare evaluation. You will work diligently to meet department productivity, quality, and customer service goals. This role will report to a Member Engagement Manager. What will you do? - Make an average of 50 outbound calls per hour placed by an automatic dialer system to offer, explain, and schedule a free in-home or virtual health evaluation with a provider - Follow 20+ approved scripts, ensure members understand and are comfortable with the terms, and respond to rebuttals persuasively and with professional courtesy - Present a positive, professional, and high energy approach to clients, health plan members, and team members - Meet daily goals set by the department (i.e., 300-400 outbound dials per day, 25 appointments set per day, shift and attendance policy adherence, quality targets, etc.) in an office or remote environment - Adjust, reschedule, and cancel appointments with both members and contracted providers, as requested - Monitor performance results including appointments, calls, handle time, and productivity using designated reporting systems - Report member complaints and escalations immediately to Member Engagement Managers - Participate in peer side-by-side coaching as needed - Follow HIPAA and other security and privacy guidelines when handling protected health information accessed during normal work activities We are looking for someone with: - A High School Diploma or equivalent is preferred - 1+ year call center experience OR 2+ years general work experience required - Previous outbound call center or high volume experience working in a metrics driven environment, with an auto dialer, and/or using scripts is preferred - A desire to work in an efficient, results-oriented outbound call center environment - Persuasive with the ability to rebuttal while treating all health plan members with professional courtesy - Good communication skills, friendly and conversational - Ability to adhere to a fixed daily schedule, including start, breaks, lunch, and end times - Strong computer skills and the ability to use multiple systems at the same time, while making calls Benefits: - Medical, Dental and Vision plans, Insurance starts the 1st of each month after the start date - Bi-weekly pay with monthly commission bonus potential - 401K, employee stock purchase program and tuition reimbursement - Employee discount programs Work From Home Requirements: To qualify, you must have verified and reliable internet service with 10MB upload/download ability available in your home. The company will provide equipment (keyboard, monitor, computer, headset, etc.). All applicants must provide their own workspace furniture and ensure a quiet workspace. Conditions of Employment: Successful completion of background check is required for this position. Location: This remote role is located in the Continental United States and requires candidates to be located within the Continental United States. Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $15.00 - $26.93 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This part‑time position is eligible for a range of benefits and programs that support the physical, emotional, and financial well‑being of colleagues. Depending on hours worked and eligibility, the benefits for this position include dental, vision, wellness resources, employee discounts, access to certain voluntary benefits, and other programs. Additional details about available benefits are provided during the application process and on Benefits Moments. This job does not have an application deadline, as CVS Health accepts applications on an ongoing basis. Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Louisville, Kentucky-based Humana is a leading healthcare company that offers a variety of health, wellness, and insurance products and services designed to off
Title: Medicare Call Center Representative - Inbound Contacts Representative II Location: United States Work Type: Remote, Full Time Job ID:414348 Job Description: Become a part of our caring community The Medicare Call Center Rep (Inbound Contacts Representative 2) represents Humana by addressing incoming telephone, digital, or written inquiries. The Medicare Call Center Rep performs varied activities and moderately complex administrative / operational / customer support assignments. Performs computations. Typically works on semi-routine assignments. In this position, you will strive to provide our Group or Individual Medicare members with a resolution or pathway to resolution on each call, while providing a perfect call experience. Among other responsibilities, you will address member needs which may include complex benefits questions, resolving issues, and educating our members. - You will handle 40+ inbound calls daily from our members in a fast-paced inbound call center environment. This is a high-volume call center setting, which may be stressful at times. - You will accurately record details of inquiries, comments or complaints, transactions or interactions, and take prompt / appropriate action, including escalating unresolved and pending member grievances. - Decisions are typically focused on interpretation of area / department policy and methods for completing assignments. - You will work under minimal direction within defined parameters to identify work expectations and quality standards but will have some latitude over prioritization / timing. - You will follow standard policies / practices that allow some opportunity for interpretation / deviation and / or independent discretion. Use your skills to make an impact Required Work Schedule: - Virtual training will start on day one of employment and runs for the first 12 weeks with a schedule of 8:00 AM to 4:30 PM EST, Monday through Friday. - You must be on time, dressed appropriately, with your camera ON for the entire duration of training and for other meetings required by leadership. Your entire face, from the shoulders up, must be clearly visible with no obstructions. - Attendance is vital for success, so no time off is allowed during training. Exception: Should a Humana-observed holiday occur during training or within the initial 120-days of employment, you will have the holiday off (paid). - All associates are subject to a 180-day appraisal period. - Following training, you will be assigned to an 8-hour shift between the hours of 8:00 AM and 8:00 PM Eastern Time, Monday through Friday. - Shift Bids take place periodically and are based on performance and business needs. - Some weekends and overtime may also be required, especially during our peak season of October through March and as needed by the business. No time off is allowed in January of each year (except Humana-observed holidays). We strive to provide a minimum of a week's advance notice for required weekends and / or overtime; however, at times business needs do not allow for a week's advance notice. - This opportunity involves working in a call center environment to support Humana Medicare members. As part of your career development for this position, you may be asked to assist with other lines of business. This will be based on business requirements and may include Member Solutions, which handles escalations. - Humana strongly supports your career growth! All Humana positions require learning many systems, policies, and tools, and it takes time to become proficient in the role. All associates who wish to apply for positions must have been in their present position for a period of twelve (12) months, unless the best interests of the company are served by a shorter period of service. Required Qualifications - You must have a minimum of 2 years of customer service experience - You must have demonstrated experience with providing strong customer service, using effective communications skills and strong attention to detail, while also actively listening to their needs - You must have prior experience managing multiple or competing priorities, including use of multiple computer applications and systems simultaneously - You must be proficient with Microsoft Office applications, particularly Outlook and Teams Preferred Qualifications - Previous inbound call center or related customer service experience - Previous healthcare experience - Associate or Bachelor's degree - Bilingual in Spanish and English (see Language Proficiency Testing below) Pay Rate - IMPORTANT: While you see an estimated pay range reflected in this job posting, the pay rate for this position is $19.24 per hour ($20.24 for Spanish / English Bilingual; requires language proficiency testing) and is non-negotiable. Work at Home Guidance To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria: - At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended (you can check your speed at speedtest.net). - Associates in this role are required to be hard-wired to their internet connection. Wireless, satellite, cellular and microwave connections are NOT permitted. - Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided with a bi-weekly payment for their internet expense. - Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job. - You must work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Language Proficiency Testing Any Humana associate who speaks with a member in a language other than English must take a language proficiency assessment, provided by an outside vendor, to ensure competency. Applicants will be required to take the Interagency Language Rating (ILR) test as provided by the Federal Government. Note: Depending on the number of openings, the number of candidates who apply, and the schedules of interviewers and recruiters, this process may take several weeks or less; however, know that we are working hard to proceed as quickly as possible and to keep you informed. Travel: While this is a remote position, occasional travel to Humana''s offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc. $39,000 - $49,400 per year Description of Benefits Humana, Inc. and its affiliated subsidiaries (collectively, "Humana") offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Recognized as a leading provider of specialized and emergency veterinary care, Ethos Veterinary Health operates a network of over 140 hospitals across North America, supported by a
Role Description The Call Center Representative (Service Center Liaison) is tasked with delivering superior care for our clients and referring veterinarians while developing relationships with the hospital teams. In joining this team you will be part of Ethos’ mission to provide unsurpassed veterinary health care to patients. Starting compensation for this position is based on experience and ranges between $17 - $20hr. - Provides superior service to clients and referring veterinarians through inbound and outbound calls - Acts as the primary point of contact for the hospitals and ensures all client and referring veterinarians’ needs are met in a professional and empathetic manner - Acts as the frontline for all emergency calls exercising a calm and compassionate demeanor - Books client appointments with accuracy and efficiency - Accurately interprets Ethos protocols to provide solutions to resolve all client and referring veterinarians’ inquiries - Processes emails, transfers medical records, and other administrative tasks Qualifications - High School Diploma or equivalent - Minimum 2 years of Veterinarian Client Care or Tech experience - Knowledge of Word, Excel, and Outlook is sufficient to perform all routine tasks including email, document preparation, and worksheet preparation - Able to work Evening shift within a 24/7-365 a year service center Requirements - A team player with proven experience to deliver an outstanding service within a high-volume environment (up to 80 calls per shift) - Excellent interpersonal skills and an ability to deal with emotionally charged client scenarios, sometimes in critical patient situations - A solid track record of exceeding productivity and quality goals - Strong communication skills, both written and oral - Good judgment and problem-solving skills Company Description Ethos is an Equal Opportunity Employer. Ethos does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, physical or mental disability, national origin, veteran status or any other basis covered by appropriate law. All employment is decided on the basis of qualifications, competence, merit, and business need.
Gainwell Technologies is an award-winning digital health technology company that supports the administration of healthcare and human services programs. In past
• Answer incoming calls promptly and professionally, addressing member or provider inquiries, and make outbound calls as needed. • Ability to remain calm and professional in high-pressure situations. • Accurately document all interactions in the system, ensuring records are updated and complete. • Maintain confidentiality and comply with HIPAA and other healthcare regulations. • Escalate complex issues to supervisors or appropriate departments when necessary. • Meet or exceed performance metrics including adhering to standardized call scripting and quality guidelines, call handle time, customer satisfaction and adhere to a daily work, lunch and break schedule.
Role Description The Outpatient Lab Coder will be responsible for advanced coding position that requires review of medical record documentation and accurately assigns ICD-10-CM, ICD-10 PCS, CPT IV codes, as well as assignment of the Medicare Severity Diagnosis Related Group (MS-DRG) / All Patient Refined - Diagnosis Related Group (APR-DRG) based on payor classification and abstracts specific data elements for each case in compliance with federal regulations. This position codes all types of inpatient and outpatient records and follows the Official Guidelines of Coding and Reporting, the American Health Information Management Association (AHIMA) Coding Ethics, as well as all American Hospital Association (AHA) Coding Clinics, CMS directives and bulletins, Fiscal intermediary communications. Qualifications - Minimum Education: High School Diploma/GED Required - Required Certifications: Coding Certification Required - RHIT/RHIA/CCS/CIC/CPC - Must be able to read, write and speak the English language in an understandable manner. - Must function independently, have flexibility, personal integrity, and the ability to work effectively with co-workers, and personnel of other departments. - Must have computational skills and knowledge of computer. - Extensive knowledge of medical terminology - Data entry skills - Problem-solving skills - Attention to detail Requirements - Reviews medical record documentation and accurately assigns appropriate ICD-10 diagnoses and procedure codes, leading to the assignment of the correct Medicare Severity-Diagnosis Related Group (MS-DRG) or All Patient Refined Diagnosis Related Group (APR-DRG). - Correctly abstract required data per facility specifications. - Responsible to assist with writing appeals for Diagnosis Related Group (DRG) denials in order to support the assigned Diagnosis Related Group (DRG) and to address the clinical documentation utilized in the decision-making process to support the validity of the assigned codes. - Responsible for monitoring and working of accounts that are Discharged Not Final Billed, failed claims, stop bills, and as a team, ensure timely, compliant processing of inpatient/outpatient accounts through the billing system. - Collaborates with coding team and members of the medical staff to ensure completeness of documentation in the charts so that appropriate codes, and ultimately the correct Diagnosis Related Group (DRG), may be assigned. - Responsible for ensuring accuracy and maintaining established quality, productivity standards, and key performance indicators. - Remain abreast of current Centers for Medicare and Medicaid Services (CMS) requirements as well as Correct Coding Initiative (CCI) edits, Hospital Acquired Conditions (HAC's) and when applicable, National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs), including the addition of appropriate modifiers to ensure a clean claim the first time through. - Other related duties as assigned. Benefits
Transformamos negócios através da tecnologia gerando resultados de impacto.
Role Description Baptist Health is looking for a Transfer Center Triage Nurse to join our team! This is a remote position that requires residency in KY or IN. The Nurse Call Center Registered Nurse implements professional nursing practice centered on the patient/care giver as a whole person focusing on healing and wellness. Provides interventions for nurse triage, facilitates patient transfers from inside and outside the organization, bed placement and other telephonic nursing functions within the transfer center as needed. Demonstrates commitment to the quality, philosophy, and values of Baptist Health by maintaining established policies and procedures, organizational objectives, process improvement, and safety standards. Hours: 8pm-8:30 am, 36 hours per week, and every third weekend. Rotating holidays. Essential Duties: - Provides telephonic nursing care by assessing patient/caller needs for nurse triage, tele-monitoring, service referrals, bed placement, and transfers. - Coordinates issue resolution and care plan for patients’ needs according to department and health system procedures. - Implements appropriate care advice according to protocols/guideline(s). - Uses critical thinking to practice objective rather than subjective modes of reasoning and action. - Ensures positive customer relations and interactions. Supports and delivers quality care by soliciting feedback from customers and takes actions to correct issues. - Effectively adjusts to changes in work processes and environment and alters behavior to align with evolving situations. - Demonstrates appropriate documentation of all calls based on department guidelines. - Handles sensitive or protected information/materials in a HIPAA compliant manner. - Completes reporting and documentation to support nurse call center operations. Qualifications - Associate degree in nursing from an accredited nursing program is required. - Bachelor’s degree in nursing preferred. - Minimum of five years nursing experience. - Current Kentucky or Indiana RN licensure. Illinois licensed required within 1 year of hire. Company Description Baptist Health is an Equal Employment Opportunity employer.
Founded in 1913, City of Hope is a national medical center offering research and treatment for life-threatening diseases, such as cancer and diabetes. Located i
Patient Access Representative Location: United States (This is a remote job) Category: Billing Job Type: Full-time Pay Rate: $18.42 - $28.44 per hour The successful candidate: ***Hours: Mon- Fri 8:00 AM-5:00 PM MST (Arizona time)** Performs all tasks related to the admission/discharge/transfer process for all patient types. Performs accurate collection of patient demographic and insurance information, to be verified upon each patient registration/check-in. Performs check-in and check-out process for all necessary appointments. Obtains all required patient registration forms, patient identification cards, and insurance cards. Prepares for upcoming appointments, reviews/provides various reports by department, answer phones, assist patients/caregivers with any questions/concerns. JOB QUALIFICATIONS Special Skills: Excellent customer service skills; Familiarity with computers, EHR, Microsoft Office products; Organized and detail oriented; Professional telephone etiquette and solid communication (verbal and written) skills; Self-starter with ability to work independently. City of Hope is an equal opportunity employer. City of Hope employees pay is based on the following criteria: work experience, qualifications, and work location
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