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Customer Service Specialist II
2 months ago
About NYC Health + Hospitals
NYC Health + Hospitals is dedicated to delivering exceptional healthcare services to the diverse communities of New York City. Our extensive range of offerings includes various health plans such as Medicaid Managed Care, Medicare, and Child Health Plus, among others. As a key player in the public health sector, we pride ourselves on our commitment to fostering strong relationships with our members and providers, ensuring that New Yorkers can lead their healthiest lives.
Position Overview
The Customer Service Specialist II plays a vital role in delivering high-quality support to our clientele. This position encompasses a variety of responsibilities, including documenting customer interactions, managing complaints, and assisting with member orientation. The Specialist will also support management with additional tasks and escalate issues as necessary.
Key Responsibilities
- Assist management with special initiatives, such as monthly provider assignments and error reports.
- Document and respond to all customer interactions, ensuring thorough follow-up and resolution.
- Conduct both in-person and telephone orientations for new and existing members.
- Aim for first-contact resolution by addressing member and provider inquiries effectively.
- Utilize technology and resources to provide accurate answers to customer questions.
- Research and respond to inquiries regarding eligibility, benefits, claims, and authorizations.
- Accurately classify and document all customer encounters.
- Identify and escalate complex issues while ensuring follow-up and resolution.
- Gather and document customer complaints, capturing all relevant details.
- Assist members in selecting primary care providers and locating services within the network.
- Verify and update member demographic information as needed.
- Process requests for member materials, including ID cards and provider directories.
- Handle inquiries related to enrollment and generate leads for potential sales.
- Manage disenrollment requests and proactively engage in retention efforts.
- Conduct outreach for new member orientations and related projects.
- Process premium payments efficiently.
- Perform additional duties and special projects as assigned by the Customer Services Director.
- Availability to work between 8:00 AM and 8:00 PM, Monday to Friday, and 9:00 AM to 5:00 PM on Saturdays.
- Participate in a paid training program during standard business hours.
- High School diploma or equivalent.
- A minimum of 3 years of experience in a high-volume call center environment.
- Demonstrated experience in providing excellent customer service in healthcare settings.
- Ability to maintain composure in challenging situations with upset customers.
- Integrity and Trust
- Customer Focus
- Technical Proficiency
- Effective Communication Skills
- Ability to thrive in a fast-paced environment with attention to detail.
