Call Center Representative II

2 weeks ago

New York, United States NYC Health Hospitals 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 Representatives (CSRs) 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 6:00PM 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

  • Call Center Representative Ii

    2 weeks ago

    New York, United States MetroPlusHealth Full time

    **Empower. Unite. Care.**: **MetroPlusHealth** is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day. **About NYC Health + Hospitals**: MetroPlus**Health**...

  • Call Center Representative II

    2 days ago

    New York, United States MetroPlusHealth Full time

    Empower. Unite. Care.MetroPlusHealth is committed to empowering New Yorkers by uniting communities through care. We believe that Health care is a right, not a privilege. If you have compassion and a collaborative spirit, work with us. You can come to work being proud of what you do every day.About NYC Health + HospitalsMetroPlusHealth provides the highest...

  • Call Center Representative

    1 month ago

    New York, United States Stratford Solutions Inc. Full time

    Job DescriptionJob DescriptionJob Titile: Call Center Representative (03:00 PM to 11:00 PM) ShiftJob Types: 12 Month ContractPay: $20.00 per hourSchedule: 8 hour shifts, 5 days a week WITH Saturday and Sunday MANDATORYCall Center Representative (03:00 PM to 11:00 PM, Saturday and Sunday MANDATORY) for non-emergency services, respond to phone inquiries from...

  • Call Center Representative

    3 weeks ago

    New York, United States Stratford Solutions Inc. Full time

    Job Titile: Call Center Representative (03:00 PM to 11:00 PM) ShiftJob Types: 12 Month ContractPay: $20.00 per hourSchedule: 8 hour shifts, 5 days a week WITH Saturday and Sunday MANDATORYCall Center Representative (03:00 PM to 11:00 PM, Saturday and Sunday MANDATORY) for non-emergency services, respond to phone inquiries from the public; provide customer...

  • Call Center Representative

    1 month ago

    New York, United States Stratford Solutions Inc. Full time

    Job DescriptionJob DescriptionJob Titile: Call Center Representative (08:00 AM to 04:00 PM) ShiftJob Types: 12 Month ContractPay: $20.00 per hourSchedule: 8 hour shifts, 5 days a week WITH Saturday and Sunday MANDATORYCall Center Representative (08:00 AM to 04:00 PM, Saturday and Sunday MANDATORY) for non-emergency services, respond to phone inquiries from...

  • Call Center Representative

    7 days ago

    New York, United States Blossom & Ivory Full time

    **Join Our Team as a Call Center Representative at Blossom & Ivory!** **Location**: New York City **About Us**: Blossom & Ivory stands as a beacon of elegance and sophistication in the heart of New York City, offering a curated selection of fashion, home decor, and lifestyle products. We are renowned for our commitment to excellence, quality, and...

  • Call Center Representative

    3 weeks ago

    New York, United States Elle Seller Full time

    Elle Seller we are seeking a highly motivated and customer-oriented Call Center Representative to join our team. As a Call Center Representative, you will be responsible for providing excellent customer service and support to our clients. You will handle a high volume of incoming calls and assist customers with their inquiries, resolve any issues, and ensure...

  • Call Center Representative

    2 months ago

    New York, United States Stratford Solutions Inc. Full time

    Job DescriptionJob DescriptionCall Center RepresentativeAvailable Shift 3:00 PM to 11:00 PM Saturday and Sunday are MANDATORYJob Description: Non-emergency services, respond to phone inquiries from the public; provide customer service and information to callers; attending to large volume of calls; take complaints and service requests and forward them for...

  • Call Center Representative

    3 weeks ago

    New York, United States Elle Seller Full time

    Job DescriptionJob DescriptionElle Seller we are seeking a highly motivated and customer-oriented Call Center Representative to join our team. As a Call Center Representative, you will be responsible for providing excellent customer service and support to our clients. You will handle a high volume of incoming calls and assist customers with their inquiries,...

  • Call Center Representative

    2 weeks ago

    New York, United States Elle Seller Full time

    Elle Seller we are seeking a highly motivated and customer-oriented Call Center Representative to join our team. As a Call Center Representative, you will be responsible for providing excellent customer service and support to our clients. You will handle a high volume of incoming calls and assist customers with their inquiries, resolve any issues, and ensure...

  • Call Center Representative

    3 weeks ago

    New York, United States Elle Seller Full time

    Elle Seller we are seeking a highly motivated and customer-oriented Call Center Representative to join our team. As a Call Center Representative, you will be responsible for providing excellent customer service and support to our clients. You will handle a high volume of incoming calls and assist customers with their inquiries, resolve any issues, and ensure...

  • Remote Call Center Representative

    6 days ago

    New York, United States New York Psychotherapy and Counseling Center Full time

    Job DescriptionJob DescriptionCompany DescriptionCelebrating 50 years of excellence, New York Psychotherapy and Counseling Center (NYPCC) has been at the forefront of mental health and wellness; assisting children, families, and individuals with behavioral and emotional challenges at our five locations throughout the city.  NYPCC is the leading...

  • Call Center Representative

    5 days ago

    New York, United States General Vision Services, LLC. Full time

    As a Call Center Representative focused on vision insurance, you will be an essential link between our organization and our valued members. Your role will involve providing exceptional customer service, addressing inquiries related to vision benefits, and ensuring a seamless experience for our policyholders and vendors. **Responsibilities**: - Inbound and...

  • Bilingual Call Center Representative

    3 weeks ago

    New York, United States CORESTAFF Services Full time

    Bilingual Call Center Representative Onsite: New York, NY 10004 Pay rate: $17.50 per hour Temp to Hire Training hours M-F 8:30 AM - 5:30 PM Job description Are you passionate about providing exceptional customer service? Do you thrive in a fast-paced environment where every day brings new challenges? If so, we have an exciting opportunity for you to join...

  • Call Center Representative

    6 days ago

    New York, United States Housing Works Full time

    Description Housing Works requires employees working in our Health Services division to be fully vaccinated against COVID-19, unless approved for a legal accommodation. If you need an accommodation for any reason, including related to this job requirement, please contact Human Resources.Job candidates should be aware that scammers may pose as employers and...

  • Bilingual Call Center Representative

    2 days ago

    New York, United States Swipejobs Full time

    Job DescriptionJob DescriptionApply Today, Work TodayWeekly PayJob Description:Are you passionate about providing exceptional customer service? Do you thrive in a fast-paced environment where every day brings new challenges? If so, we have an exciting opportunity for you to join our team as an Onsite Call Center Representative.As an Onsite Call Center...

  • Lead Call Center Representative

    2 days ago

    New York, United States SPS Global Full time

    The **Lead Call Center Representative **will be responsible for general information and inbound sales calls for the Rockefeller Center attractions to including but not limited to - Top of the Rock Observation Deck, The Rink, Rock Center Tour and The Rainbow Room. The Call Center rep will also be responsible for supporting the sales team on booking seasonal...

  • Call Center Representative

    7 days ago

    New York, United States Cogent Infotech Corporation Full time

    Job DescriptionJob DescriptionJob Title: Call Center Representative / CSRLocation: Long Island City, NY 11101Duration: 6+ monthsOpen available to work shift schedules at any given time from 6 am to 12 am.Shifts are as follows: 6am-2pm, 6:30am-2:30pm, 7am-3pm,7:30am-3:30pm, 8am-4pm,...

  • Call Center Representative

    3 days ago

    New York, United States Cogent Infotech Corporation Full time

    Job DescriptionJob DescriptionJob Title: Call Center Representative / CSRLocation: Long Island City, NY 11101Duration: 6+ monthsOpen available to work shift schedules at any given time from 6 am to 12 am.Shifts are as follows: 6am-2pm, 6:30am-2:30pm, 7am-3pm,7:30am-3:30pm, 8am-4pm,...

  • Call Center Representative

    7 days ago

    new haven, United States Fair Haven Community Health Care Full time

    Fair Haven Community Health Care FHCHC is a forward-thinking, dynamic, and exciting community health center that provides care for multiple generations at nearly 140,000 office visits in 19 locations. Overseen by a Board of Directors, the majority of whom are patients themselves, we are proud to offer a wide range of primary and specialty care services,...