Medicaid Member Service Representative - Remote

ABOUT US:

CEF Solutions Inc. is a Consulting Services and Business Process Outsourcing (BPO) company specializing in BPO Operations, Operations Management, Process Engineering and Innovation, Cost Optimization, and Staffing solutions. We take pride in our expertise in providing specialized staffing services, ensuring that clients have access to top talent that aligns with their operational goals. We service some of the largest multinational companies in the world and are expanding quickly by delivering an unmatched end-to-end client experience.

Company website: www.CEF.inc

We are hiring Medicaid Member Service Representatives to work from home!

Position Overview:

· Location: Work at home

· Hourly rate of pay: $14/hr. Training; $16.50/hr. after 1 week of production

· Start Date: 11/14/2025

· Training Schedule: Mon Fri; 8:00 AM 4:30 PM Eastern

o Length of Training: 4 weeks training, 2 weeks nesting

· Project duration: Steady State - This project operates without a predetermined end date, and it is based on agent performance and the clients needs

· Hours of Operation (HOOPs): Mon Fri; 9:00 AM 9:30 PM Eastern

· Production Schedule Post Training:

o An assigned schedule between the hours of operation

· 40 hours per week.

· 8 hours per day + 30 min lunch

· Scheduled 5 days a week

Medicaid Member Service Representatives will primarily handle inbound calls, with occasional outbound outreach as needed. During periods of low call volume, representatives may be assigned small projects, asked to review updated knowledge base articles, or review quality assurance feedback. This is a fully remote role - train from home and work from home.

Responsibilities:

· Handle a minimum of 50 calls per day, providing exceptional customer service to members, providers, and other stakeholders

· Assist with a variety of inquiries, concerns, requests, and complaints in a professional and tactful manner

· Educate members on plan procedures, benefits, and services, maintaining a calm and helpful demeanor even when dealing with complaints

· Maintain a "willing to assist" attitude and ensure consistent quality service throughout the workday

· Meet and exceed call center metrics, including call volume, quality scores, schedule adherence and NPS

Required Qualifications:

· Minimum of one year of experience in healthcare or health plan settings

· Minimum of one year of customer service and/or call center experience

· High school diploma or equivalent

· Strong commitment to providing high-quality customer service on every call

· Proficiency with Windows platforms and MS Office Suite (Word, Excel)

· Ability to build and maintain positive and effective relationships with coworkers, clients, members, and providers, even while working remotely

· Excellent verbal and written communication skills

· A quiet, dedicated workspace at home with reliable internet connectivity

Preferred Qualification:

· Knowledge of or experience with Medicaid Managed Care