Customer Service Representative

Job overview: Join our Team as a Customer Service Representative to support Florida Medicaid providers and members by answering claims and eligibility-related inquiries. In this role, you will provide excellent customer service, conduct self-research using Medicaid resources, and follow up on unresolved cases to ensure resolution. This position requires strong verbal communication skills, problem-solving abilities, and a commitment to detailed documentation. You will have access to reference materials and resources to guide providers and members effectively.

WORKSITE: willing to work in-office at least three times per week.

WORK SCHEDULE: Full-time position with structured weekday hours (8:30 AM - 5:00 PM, Monday-Friday)

COMPENSATION: $16.00 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 for all employees and their families
• Additional volunteer options such as Group Life Insurance, Accidental Insurance, Critical Care, Short Term Disability

WHAT YOU'LL DO:

• Answer 40-50 inbound calls daily from Florida Medicaid providers and member beneficiaries, delivering excellent customer service.
• Resolve claims, eligibility, and billing inquiries, ensuring accurate information is provided.
• Conduct self-research using Medicaid resources and the Medicaid website for policy-related questions.
• Follow up on complex issues, ensuring proper call resolution, including callbacks and closing call references.
• Maintain detailed call logs and document interactions for future reference.
• Escalate complex, non-routine inquiries to supervisors when needed.
• Assist providers in navigating Medicaid web services and other online resources.
• Support and train new team members as needed.

WHAT YOU'LL BRING:

• Two or more years of customer service experience, either face-to-face or via phone.
• Strong verbal communication skills and ability to ask fact-finding questions.
• Detail-oriented with excellent documentation and note-taking skills.
• Reliable and punctual, with a commitment to follow through on tasks.
• Proficient in typing and computer navigation.
• Minimum of a high school diploma or GED.
• Previous experience in a professional customer service setting is preferred.

Fortuna operates as a staffing agency that sources, screens, and presents potential candidates for employment opportunities on behalf of our clients.

Fortuna was founded in 2012 by practicing professionals with more than 50 combined years of experience. Our headquarters is 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: www.gofortuna.com.