CCO Service Agent - Remote

Overview

The Service Agent supports Contact Center Operations by delivering an exceptional customer experience to members and providers. This role handles inquiries, resolves complaints, educates clients, retains members, helps prevent disenrollments, and escalates issues across all Lines of Business within traditional and/or Omni-channel contact center environments. The incumbent contributes to Healthfirst’s culture and drives improvements to ensure the best possible experience for North Star Members and the Providers who serve them.

• Provide excellent quality customer service to members and/or providers on eligibility, benefits, claims process, escalations, product questions, and related issues.
• Manage inbound/outbound calls, emails, chats, onsite/remote/virtual interactions, and other channel activities on behalf of CCO.
• Meet or exceed performance KPIs including quality, productivity, and dependability.
• Follow established policies and procedures to ensure timely and accurate resolution of member and provider issues.
• Identify and de-escalate upset member/provider interactions and provide resolutions.
• Initiate investigations and participate in root cause analyses; propose and implement process improvements; follow up on outstanding inquiries within defined time frames.
• Comply with HIPAA requirements and maintain confidentiality of PHI; adhere to local, state, federal, and Healthfirst regulatory guidelines.
• Build sustainable relationships of trust through open and interactive communication with internal and external customers.
• Maintain a flexible schedule, including late shifts, weekends, and/or holidays with limited notice as needed and during unforeseen disruptions.
• Perform additional duties as required.

• High School Diploma or GED from an accredited institution.
• Experience in a customer service environment.
• Experience participating in cross-functional projects and departmental initiatives related to customer interaction and service.
• Experience working in a fast-paced environment.
• Proficient in Microsoft Office Suite (Excel, Word, Outlook).

• Associate’s or Bachelor’s Degree from an accredited institution or equivalent work experience.
• Proven ability to think independently, solve problems, and achieve goals.
• Knowledge and experience with traditional and/or omnichannel contact centers, with emphasis in healthcare (KPIs, CMS/NYSOH requirements, CMS STARS programs) and call center operations.
• Experience navigating multiple technologies including a CRM system (locating information, routing actions, notating resolutions, updating member information).
• Basic knowledge of operational health plan departments and functionality; working knowledge of Microsoft Office PowerPoint.
• Excellent verbal and written communication; ability to document grammatically correct emails, communications, and presentations.
• Basic understanding of call center metrics (e.g., Average Handle Time, Quality).

See above.

N/A

HF Management Services, LLC is an equal opportunity employer. We comply with applicable laws and regulations. Applicants are evaluated without regard to race, color, creed, religion, sex, national origin, sexual orientation, pregnancy, age, disability, genetic information, domestic violence victim status, gender identity or expression, military status, veteran status, citizenship or immigration status, height and weight, familial status, marital status, or unemployment status, and other legally protected bases.

Reasonable accommodations for disabilities are available upon request via careers or . Only accommodation requests related to applying for a position will be reviewed. Thank you for considering a career with Healthfirst.

Know Your Rights:
All hiring and recruitment at Healthfirst uses valid healthfirst.org email addresses or recruitment partners. Be cautious of communications from non-healthfirst domains. Healthfirst does not ask for money during recruitment or onboarding. Salary ranges:
Greater New York City Area: $40,200 - $54,570;
Other Locations: $34,900 - $52,000. Compensation depends on experience, education, licenses, and certifications, and other factors. Healthfirst offers a full range of benefits including medical, dental, vision, life insurance, and 401(k) contributions, subject to eligibility.