Service Representative - Remote WI

It takes great medical minds to create powerful solutions that solve some of healthcare’s most complex challenges. Join us and put your expertise to work in ways you never imagined possible. We know you’ve honed your career in a fast-moving medical environment. While Gainwell operates with a sense of urgency, you’ll have the opportunity to work more flexible hours. And working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work-life balance, continuous learning, and career development.

Summary

The CLTS Service Representative is integral to supporting the Wisconsin Children's Long-Term Support (CLTS) program. This role involves researching and resolving inquiries from various stakeholders, including providers, County Waiver Agencies (CWAs), and the Wisconsin Department of Health Services (DHS). The ideal candidate will effectively use internal systems to address questions and issues, ensuring customer satisfaction through timely and quality responses. This position also involves occasional training sessions, both onsite and virtual, and requires independent decision-making within a team-oriented environment.

Your role in our mission

• Research & Resolution: Address and resolve third-party administrator (TPA) questions and issues from providers, CWAs, and DHS staff.
• Systems Utilization: Use internal software tools to research and resolve inquiries effectively.
• Customer Satisfaction: Ensure high levels of customer satisfaction by providing timely and accurate responses.
• Relationship Building: Develop and maintain strong business relationships with all stakeholders.
• Training & Education: Conduct occasional onsite or virtual training sessions for providers, CWAs, and DHS staff.
• Independent Decision-Making: Manage responsibilities and make independent decisions with limited supervision.

What we're looking for

• Experience: 1-3 years of relevant work experience in a related field is desired.
• Healthcare Knowledge: A solid understanding of Wisconsin Medicaid and general knowledge of commercial and government healthcare insurance programs.
• Problem-Solving Skills: Excellent research and problem-solving skills are crucial for this role.
• Communication Skills: Ability to communicate effectively and professionally with all stakeholders.
• Technical Proficiency: Proficiency in using computers, including Microsoft Office, and the ability to learn organization-specific software.

What you should expect in this role

• Team Environment: Collaborate with a team while managing your own responsibilities independently.
• Learning Opportunities: Gain in-depth knowledge of internal policies, procedures, and systems.
• Customer Interaction: Regularly interact with providers, CWAs, and DHS staff to resolve inquiries and issues.
• Training Responsibilities: Be prepared to lead or participate in training sessions to educate stakeholders.
• Dynamic Workload: Expect a mix of routine tasks and unique challenges that require creative problem-solving.
• Growth Potential: Opportunities for professional growth and skill development within the organization.

#LI-REMOTE

#LI-JT1

#LI-CM1

The pay range for this position is $54,300.00 - $77,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.