Customer Service Representative - Provider and Member Support - Warwick, RI (Hybrid)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

Provides customer service support for Rhode Island Medicaid providers and members by handling claims, eligibility, benefit plans, premium payments, and enrollment inquiries. Responsibilities include researching Medicaid policies and procedures, resolving calls and follow-ups, asking fact-finding questions, and providing accurate information using available reference materials.

Performs manual data entry for member benefit enrollment programs, supports claims resolution by coordinating with the Claims team, and processes claims for payment or denial when additional requirements are needed. Supports Provider Enrollment through provider mailings and medical license renewal requests, as well as quality control reviews of Provider Enrollment entries.

Strong verbal communication, customer service, attention to detail, and problem-solving skills are required. Previous medical or medical billing experience is preferred but not required.

Your role in our mission

• Answer an estimated 40-50 inbound calls daily from the Rhode Island Medicaid provider network and member beneficiaries. Providing excellent oral communications with quality customer service. Follow through and resolving all calls.
• Address billing and eligibility questions with your commitment to follow up as necessary to resolve.
• Create and manage computer call logs/references.
• Provide excellent customer service to include offering added assistance as appropriate. This includes becoming familiar with web service offerings in order to direct a provider to these offerings.
• Train and support peers and new team members

What we're looking for

• Two years or more of customer service experience, either face-to-face or by phone. 
• Detail oriented
• Prompt and reliable
• Good typing and computer skills 
• Excellent verbal communication and Customer Service skills

What you should expect in this role

• Minimum of a high school diploma or GED. 
• Previous customer service experience in a professional setting. - Warwick, RI

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• The deadline to submit applications for this posting is October 30, 2026.

The pay range for this position is $29,100.00 - $41,600.00 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 , 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 and visit our for all available job role openings.

Gainwell Technologies is 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), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.