Customer Service Representative II

4 days ago


Brooklyn, New York, United States MetroPlus Health Plan Full time
Job Summary

We are seeking a highly skilled Customer Service Representative II to join our team at MetroPlus Health Plan. As a key member of our Call Center, you will be responsible for providing exceptional service to our customers, addressing their inquiries, and resolving their issues in a timely and professional manner.

Key Responsibilities
  • Respond to customer inquiries and resolve issues via phone, email, or in-person
  • Document all customer interactions in our tracking system
  • Assist management staff with special projects and initiatives
  • Provide on-site and telephone orientations to new and existing members
  • Utilize 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 and provide follow-up/closure
  • Process requests for member materials, such as ID cards, member guides, 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
  • Perform other duties and special projects as assigned by the Director of Customer Services
Requirements
  • High School graduation or evidence of having satisfactorily passed a High School Equivalency Program
  • 3 years of experience in a call center environment handling high volumes of calls
  • Proven experience in providing excellent service to customers in various 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


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