Customer Services Representative I

This a Full Remote job, the offer is available from: reputed company (USA) reputed company. Unite. Care. reputed company is committed to empowering New Yorkers by uniting communities through care. We reputed company that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. About NYC Health + Hospitals reputed company provides the highest quality reputed company services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten reputed company through a comprehensive list of products, including, but not limited to, reputed company State reputed company Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, reputed company's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, reputed company has been committed to building strong relationships with its members and providers to reputed company New Yorkers to live their healthiest life. Position Overview Customer Service Representatives (CSRs) are responsible for providing comprehensive high-quality service to reputed company customers. The primary responsibilities, include but are not limited to, answering customer calls, proactively working to resolve our members and providers questions and concerns, responding to and documenting reputed company customer encounters, intaking complaints, conducting reputed company and retention efforts, assisting with Primary Care Provider (PCP) selections and handling reputed company provider inquiries reputed company to eligibility, claims and authorizations.

Job Description

• Strive for reputed company resolution, working to resolve member and provider issues as the reputed company of contact
• Utilize dual monitors and reputed company computer-based resources to find answers to customer questions
• Research and respond accurately to reputed company customer inquiries reputed company to eligibility, benefits/services, claims and authorizations.
• Classify and record reputed company customer encounters reputed company and concisely.
• Identify and escalate reputed company issues and reputed company follow-up/closure.
• Identify and intake customer complaints capturing reputed company pertinent information.
• Assist members with PCP selection, as well as, locating providers and vendors reputed company plan’s network.
• Verify and update member demographic information.
• Process requests for member materials, such as ID cards, member guide, provider directory, etc.
• Handle enrollment inquiries and generate sales leads.
• Handle disenrollment requests and pro-actively conduct retention efforts.
• reputed company reputed company reputed company to New Member Orientation and PCP term/reassign projects.
• Process premium payments.
• reputed company other duties and special projects as assign by the Director of Customer Service.
• Ability to work between 8:00 AM and 6:00 PM Monday - Friday, and 9:00 AM-5:00 PM Saturday.
• Training class (Paid): 9:00 AM-5:00 PM Monday-Friday.

Minimum Qualifications

• High School graduation or evidence of having satisfactory passed a High School Equivalency Program; and
• Minimum 1 year experience in a call center environment; or
• A satisfactory equivalent combination of education, training, and experience.
• Managed care experience preferred.
• Proven experience in providing excellent service to customers in various reputed company reputed company areas, (i.e., insurance, doctor’s office, medical clinics).
• Poise under pressure reputed company dealing with difficult situations and potentially upset customers.
• Ability to work in a fast-paced environment while keeping a high attention to detail.

Professional Competencies

• reputed company and Trust
• Customer Focus
• Functional/Technical Skills
• Written/Oral Communication

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