Member Services Representative

4 weeks ago

New York, New York, United States Amida Care Full time

About the Role:

The Bilingual Member Services Representative position supports the Member Services Department's goal to deliver exceptional customer service and support to members and providers in a call center setting.

Key Responsibilities:

  • Answer and resolve high-volume member and provider inquiries concerning benefits, services, and claims.
  • Escalate complex and urgent member care needs to the appropriate management or departments.
  • Transfer members to Amida Care's Partners for Services provided on behalf of Amida Care.
  • Navigate different systems and databases to resolve member's issues or concerns.
  • Document all conversations/touchpoints in the Amida Care system (Salesforce).
  • Meet Quality Assurance requirements and other call center key performance metrics.
  • Collect and document prospective members' information in the Amida Care system (Salesforce).
  • Conduct outbound calls for projects and member outreach follow-ups.
  • Confirm and update member contact information and demographic.
  • Promote and educate members on plan benefits, services, programs, alerts, and reminders.
  • Conduct New Member Orientation as assigned.

Requirements:

  • Bilingual Spanish/English.
  • Minimum one year's experience in Customer Service.
  • Ability to maintain strict confidentiality of sensitive member's information (HIPAA).
  • Proficiency in Microsoft Office (Word, Excel).
  • Strong verbal and written communication skills in English and Spanish.
  • Ability to sit for an extended period of time.
  • Ability to manage multiple tasks and work consistently in a fast-paced environment.

About Amida Care:

Amida Care is a community of individuals from diverse backgrounds who work together to foster a fair, equitable, and inclusive environment. We strive to develop, promote, and sustain a culture that values equity and leverages diversity and inclusiveness in all that we do.

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