Member Services Representative
6 days ago
Amida Care, a leading Medicaid HIV Special Needs Plan in New York, is seeking a highly motivated and experienced professional to join our team as a Member Services Representative. Our innovative care model has become a benchmark for excellence in member health outcomes, and we are committed to providing access to comprehensive care and coordinated services that foster positive health outcomes and well-being for our members.
Key Responsibilities:- Provide exceptional customer service to members and providers, addressing benefits, services, and claims inquiries in a timely and professional manner.
- Escalate complex and urgent member care needs to management or other departments, ensuring seamless resolution and member satisfaction.
- Navigate various systems and databases to resolve member issues and concerns, maintaining confidentiality and adhering to HIPAA guidelines.
- Document all conversations and touchpoints in our Salesforce system, ensuring accurate and up-to-date member information.
- Meet quality assurance requirements and other call center key performance metrics, demonstrating a commitment to excellence and continuous improvement.
- Collect and document prospective member information in our Salesforce system, facilitating a smooth onboarding process.
- Conduct outbound calls for projects and member outreach follow-ups, promoting plan benefits, services, and programs to enhance member engagement and satisfaction.
- Confirm and update member contact information and demographics, ensuring accurate and timely communication.
- Promote and educate members on plan benefits, services, programs, alerts, and reminders, fostering a culture of informed and empowered members.
- Conduct New Member Orientation as assigned, providing a comprehensive introduction to our care model and services.
- High School Diploma or equivalency certificate.
- Minimum one year of experience in customer service, with a strong track record of providing exceptional service and resolving complex issues.
- Proficiency in Microsoft Office (Word, Excel) and ability to navigate various systems and databases.
- Strong verbal and written communication skills, with the ability to communicate effectively with diverse populations.
- Ability to sit for extended periods and manage multiple tasks in a fast-paced environment.
Amida Care is an equal opportunity employer committed to diversity, equity, and inclusion. We strive to create a culture that values equity and leverages diversity and inclusiveness in all that we do. Amida Care requires that all candidates selected for employment must provide proof of full Covid-19 vaccination upon acceptance of an offer of employment.
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