Call Center Representative II
New York, New York
Employer: NYC Health Hospitals
Industry: CALL CENTER
Salary: Competitive
Job type: Full-Time
MetroPlusHealth provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid 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, MetroPlusHealth's network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlusHealth has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.
Position Overview
Call Center Reps are responsible for providing comprehensive high-quality service to all customers. The primary responsibilities, include but are not limited to documenting all customer contacts into the tracking system, process complaints, conduct outreach efforts, assist in PCP selection, conduct new member orientations, claims review inquiries, handle provider and utilization management inquiries, etc. Under the Level II title, the Call Center Representative will continue Level I functions and be assigned additional responsibilities in areas that require assistance such as providing support to management staff and escalate issues within Call Center.
Job Description
Minimum Qualifications
Professional Competencies
#LI-Hybrid
Position Overview
Call Center Reps are responsible for providing comprehensive high-quality service to all customers. The primary responsibilities, include but are not limited to documenting all customer contacts into the tracking system, process complaints, conduct outreach efforts, assist in PCP selection, conduct new member orientations, claims review inquiries, handle provider and utilization management inquiries, etc. Under the Level II title, the Call Center Representative will continue Level I functions and be assigned additional responsibilities in areas that require assistance such as providing support to management staff and escalate issues within Call Center.
Job Description
- Assist management staff with special projects: i.e., PCP monthly projects (MIS-Assignments, PCP error reports)
- Record and respond to all Customer contacts and update in tracking system. Manage and ensure appropriate follow-up and closure for all customer contacts.
- Provide on-site as well as telephone orientations to new and existing members.
- Strive for first call resolution, working to resolve member and provider issues as the point of contact
- Utilize dual monitors and leverage computer-based resources to find answers to customer questions
- Research and respond accurately to all customer inquiries related to eligibility, benefits/ services, claims and authorizations.
- Classify and record all customer encounters clearly and concisely.
- Identify and escalate complex issues and provide follow-up/ closure.
- Identify and intake customer complaints capturing all pertinent information.
- Assist members with PCP selection, as well as, locating providers and vendors within 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.
- Perform outreach related to New Member Orientation and PCP Term/ Resign projects.
- Process premium payments.
- All other duties and special projects as assign by the Director of Customer Services.
- Ability to work between 8:00AM and 8:00PM Monday - Friday, and 9:00AM-5:00PM Saturday
- Training class (Paid): 9:00AM-5:00PM Monday-Friday
Minimum Qualifications
- High School graduation or evidence of having satisfactory passed a High School Equivalency Program; and
- 3 year of experience in a call center environment handling high volume of calls required
- Proven experience in providing excellent service to customers in various healthcare related areas, (i.e. insurance, doctor's office, medical clinics)
- Poise under pressure when dealing with difficult situations and potentially upset customers
Professional Competencies
- Integrity and Trust
- Customer Focus
- Functional & Technical Skills
- Written/Oral Communication
- Ability to work in a fast-paced environment while keeping a high attention to detail
#LI-Hybrid
Created: 2024-08-30
Reference: 109736
Country: United States
State: New York
City: New York
ZIP: 10036
Similar jobs:
-
Pharmacy Support Center Representative
Wegmans in Rochester, New York -
Call Center Representative III
University of Rochester in Rochester, New York💸 $19.47 - $25.77 per hour -
Welcome Center Representative, Clinics
University at Buffalo in Buffalo, New York💸 $34125 - $38025 per year -
Call Center Representative-VIVO Pharmacy
Northwell Health in Lake Success, New York💸 $41780 - $64340 per year -
Call Center Representative
SPECTRUM in Rochester, New York💸 $41600.00 per year -
Business Services Center Representative 1 (NY HELPS) VID 163220
StateJobsNY in Albany, New York -
Call Center Representative II
University of Rochester in Rochester, New York💸 $18.71 - $25.27 per hour -
Inside Sales Center Representative
Renewal by Andersen in Schenectady, New York -
Call Center Representative
Upstate University Hospital in Syracuse, New York -
Ambulatory Call Center Representative
Upstate University Hospital in Syracuse, New York -
Regional Operations Center Representative - Rochester
SPECTRUM in Rochester, New York💸 $20.00 - $29.15 per hour -
Contact Center Trainer (Training and Development Representative), Contact Center
NYC Health Hospitals in New York, New York -
Call Center Representative II
University of Rochester in Rochester, New York💸 $18.71 - $25.27 per hour -
Contact Representative - Women Veterans Call Center
Veterans Health Administration in Canandaigua, New York -
Call Center Representative
Upstate University Hospital in Syracuse, New York -
Patient Access Representative - Call Center
Stony Brook Medicine in Commack, New York💸 $49139 - $54253 per year -
Call Center Representative II
University of Rochester in Rochester, New York💸 $18.71 - $25.27 per hour -
Contact Center Representative - Bellevue (Clerical Associate Level IV), Call Center
NYC Health Hospitals in New York, New York -
Call Center Representative, (NYSHELPS) Item #153917
StateJobsNY in Menands, New York -
Call Center Representative II
University of Rochester in Rochester, New York💸 $18.71 - $25.27 per hour