Customer Service Representative
: Job Details :


Customer Service Representative

PRIDE Health

Location: New York,NY, USA

Date: 2024-12-21T05:13:27Z

Job Description:

We're looking for Customer Service Representative for our client with a leading hospital in New York, NY.

Please find below details of the position.

Position: Customer Service Representative - Hybrid Role

Location: New York, NY.

Duration: 2 months contract with extension possibilities.

Shift: 9 AM to 5 PM, required to work 1 Saturday a month (9 AM - 5 PM). Rotation on 1 late night alt weeks of 12-8 PM with flexibility.

*2 days in office, 3 days remote (field work not required)

Pay - $23/hr

Scope of Role & Responsibilities:

  • Recertification/renewal of membership
  • Assist all line of business (Medicaid/Medicare/MLTC/CHP/EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours, field locations as well as weekends. This is designed to optimize telephone outreach with members due to recertify.
  • Follow appropriate processes to meet and exceed recertification targets set by the department
  • Make the recertification process as easy and seamless as possible for our members
  • Assisting members with completion of recertification applications
  • Partner with different parts of the organization to understand any barriers to the member's experience and work to resolve them appropriately
  • Maintaining daily Outreach and Renewal goals set through business needs to increase overall retention
  • Enrollment and retention support
  • Assisting members with completion of all enrollment activities including but not limited to changing lines of business to ensure member is in the optimal plan, re-enrolling members due to administrative issues, premium payment etc.
  • Assist members with PCP selection as well as locating providers and vendor within plan's network
  • Providing end to end customer support to drive customer satisfaction and improve customer experience
  • Interfacing with internal and external stakeholders to ensure complete resolution
  • Communicating verbally and in writing with members for all necessary Member Retention activities
  • Process improvements:
  • Devising solutions in response to member dissatisfaction/ complaints/issues to support ongoing organizational improvement efforts
  • Support any ad hoc projects on process improvements
  • Report common trends identified during member outreach
  • Other duties as assigned

Required Education, Training & Professional Experience:

  • Associate's Degree and minimum 1 year of experience in direct consumer contact, including, but not limited to, customer engagement, customer services, sales, community engagement.; OR
  • High school degree and 3-5 years of experience in direct consumer contact, including, but not limited to, customer engagement, customer services, sales, community engagement; Healthcare especially Managed Care experience preferred but not required.
  • Bi-lingual preferred
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