The Operations Call Center Service Agent is responsible for assisting members & providers with issues and inquiries about our members and their insurance, applications and/or claims in one or more families of products, i.e. Medicare, Medicaid. The Service Agent is also responsible for receiving and addressing member & provider inquiries, resolution of complaints, client education, retention of membership and dis-enrollments, and escalation of issues requiring additional intervention.
We are now taking applications for our upcoming Fall Call Center Service Agent Class!
**This position is eligible for hire in the following states: FL, GA, NC, SC, TN, PA, NY, NJ, TX, MN, VA
Paid Virtual Training: 6 weeks of classroom based training, between the hours of 930am to 530pm, depending on the required shift, Monday through Friday.
Work Schedule: Must be available to work any shift between 8am to 8pm including weekends and holidays as needed. This may periodically change to meet business needs.
Salary:
Candidates hired in New York or New Jersey will start at $19.66 or greater per experience and language proficiency.
Candidates hired in Pennsylvania, Texas, Minnesota, Virginia or Tennessee will start at $17.06 or greater per experience and language proficiency.
Candidates hired in Florida, Georgia, North Carolina or South Carolina will start at $16.25 or greater per experience and language proficiency.
This role is overtime eligible PLUS quarterly incentives based on performance.
Benefits: Outstanding benefits package including: Medical, Dental, Vision, Basic Life & Accident Insurance, Flexible Reimbursement Accounts, Employee Assistance Plan, Healthfirst 401(k) plan plus much more!
Duties & Responsibilities:
Provide high quality telephone assistance (incoming / outgoing ) to all members and providers as required.
Resolve inquiries and issues relating to all aspects of member/provider questions and issues such as eligibility, benefits, claims, process and product questions, etc.
Meet all applicable metrics as well as quality standards set by leadership.
De-escalate situations where the customer is upset and/or frustrated and provide resolution for their issue.
Escalate calls to a Senior Service Agent or Team Lead, as needed.
Route cases or transfer calls to other departments as appropriate.
Follow-up on outstanding customer inquiries and complaints within defined timeframe.
Navigate multiple technologies including a Customer Relationship Management System to find information, route future actions, notate resolutions, update member information, etc.
Multi-task, prioritize, and manage time effectively.
Perform research on billing inquires and claims to provide payment and refunds, if applicable.
Comply with HIPAA guidelines and maintain confidentiality of member, provider, medical and departmental information. Adhere to state and federal compliance and regulatory guidelines.
Make recommendations to management concerning problems, problem trends and process improvement.
Work a flexible schedule, nights, weekends, holidays, and/or overtime with limited notice.
Additional duties as assigned.
Minimum Qualifications:
Experience providing quality service across a broad range of business topics.
Face to face or telephonic customer service experience.
Working experience with Microsoft Office Suite applications including Excel, Word, PowerPoint, and Outlook.
High school diploma or GED from an accredited institution.
Preferred Qualifications:
Highly preferred: ability to read, write and speak English and any of the following languages: Spanish, Mandarin, Cantonese, Russian
Conflict resolution experience.
Experience handling complex situations and/or projects.
Healthcare industry or call center experience.
Associates degree from an accredited institution.
Certificate in medical billing and coding.
Compliance & Regulatory Responsibilities: See Above
License/Certification: N/A
WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.
If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to [email protected] or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.
All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.
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