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Call Center Representative II

1 month ago


New York, New York, United States NYC Health Hospitals Full time
Job Title: Call Center Representative II

MetroPlusHealth is a leading healthcare provider in New York City, serving residents of the five boroughs through a comprehensive range of products and services. As a Call Center Representative II, you will play a critical role in delivering exceptional customer service to our members, ensuring their needs are met and their health is prioritized.

Key Responsibilities:
  • Provide high-quality service to all customers, responding to their inquiries and resolving issues in a timely and professional manner.
  • Document all customer contacts in our tracking system, ensuring accurate and up-to-date information.
  • Assist management staff with special projects, such as PCP monthly projects and error reports.
  • Provide on-site and telephone orientations to new and existing members, ensuring a smooth transition to our services.
  • Strive for first call resolution, working to resolve member and provider issues as the point of contact.
  • Utilize dual monitors and computer-based resources to find answers to customer questions.
  • Research and respond accurately to customer inquiries related to eligibility, benefits, services, claims, and authorizations.
  • Classify and record all customer encounters clearly and concisely.
  • Identify and escalate complex issues, providing follow-up and closure.
  • Assist members with PCP selection, locating providers and vendors within our network.
  • Verify and update member demographic information.
  • Process requests for member materials, such as ID cards and provider directories.
  • Handle enrollment inquiries and generate sales leads.
  • Handle disenrollment requests and proactively conduct retention efforts.
  • Perform outreach related to New Member Orientation and PCP Term/Resign projects.
  • Process premium payments.
Requirements:
  • High School graduation or equivalent.
  • 3 years of experience in a call center environment handling high volumes of calls.
  • Proven experience in providing excellent service to customers in healthcare-related areas.
  • 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 maintaining a high attention to detail.