Customer Service Representative

Job Title:

Customer Success Specialist I

Work Schedule:

Full time
Hours Per Week: 35
Days:
Monday, Tuesday, Wednesday, Thursday, Friday
Shift time: 9am - 5pm

Work location:

Hybrid
Patient Facing:
No

• First point of contact for all customer service issues.
• Responsible for ensuring patient/client medications, supplies and equipment are accurately recorded and sent to distribution.
• Consults with Supervisors to ensure timely and accurate delivery of supplies/equipment.
• Maintains patient privacy and confidentiality at all times according to established procedures.
• Provides positive, supportive communication to supervisor, patients, families, visitors and company personnel.
• 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 as well as weekends, designed to optimize telephone outreach with members who are 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.
• Assist 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.
• Meet daily outreach and renewal goals that contribute to overall member retention for the organization.
• Assist 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 vendors within the Plan’s network.
• Provide end-to-end customer support to drive customer satisfaction and improve customer experience.
• Interface with internal and external stakeholders to ensure complete resolution.
• Communicate verbally and in writing with members for all necessary member retention activities.
• Devise solutions in response to member dissatisfaction/complaints/issues in support of ongoing organizational improvement efforts.
• Support any ad hoc projects on process improvements.
• Report common trends identified during member outreach.

• Minimum education level:
  High school.
• Language competencies: bilingual preferred – English & Spanish, but also interested in English & Chinese, Russian, Bengali.
• License/Registration required.