Customer Service Representative
1 week ago
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 supported.
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.
- Conduct on-site and telephone orientations for 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 and provide accurate responses.
- Research and respond to customer inquiries related to eligibility, benefits, services, claims, and authorizations.
- Classify and record all customer encounters clearly and concisely, identifying and escalating complex issues as needed.
- Identify and intake customer complaints, capturing all pertinent information and providing follow-up and closure.
- Assist members with PCP selection, locating providers and vendors within our network, and verifying and updating member demographic information.
- Process requests for member materials, such as ID cards, member guides, and provider directories.
- Handle enrollment inquiries, generate sales leads, and process disenrollment requests, proactively conducting retention efforts.
- Perform outreach related to New Member Orientation and PCP Term/Resign projects.
- Process premium payments and perform other duties as assigned by the Director of Customer Services.
- High School graduation or equivalent, and 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, such as insurance, doctor's offices, and medical clinics.
- Poise under pressure when dealing with difficult situations and potentially upset customers.
- 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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