Description and Requirements
Duties and Responsibilities
· Provides high quality assistance to the team via phone, chat, video call, email, in person, and/or other communication channels related to servicing our members and/or providers. May include but is not limited to inbound/outbound calls/emails/chats, onsite/remote/virtual/field location, onshore/offshore, on behalf of CCO.
· Responsible for meeting assigned departmental productivity, quality, dependability standards, and assist and resolve complex member/provider inquires and escalations.
· Identifies potential quality and performance issues and takes proactive approach to recommend solutions and methods for process improvement.
· Complies with HIPAA requirements and maintains Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information. Ensures adherence to local, state, federal and Healthfirst specific compliance and regulatory guidelines.
· Assists Team Leads with general departmental/corporate communication(s) to team members
· Responsible for assisting with new hire training/cross training/refresher training as needed
· Provides status reports to Team Lead on assigned activities
· Builds sustainable relationships of trust through open and interactive communication with internal and external customers.
· Works a flexible schedule including a late shift, weekends, and/or holidays (with limited notice at times), and as needed during unforeseen business disruptions.
· Additional duties as required.
Minimum Qualifications:
- High School Diploma or GED from an accredited institution.
- Experience working in customer service for a contact center.
- Experience in resolving escalated customer complaints or concerns, complex situations and/or projects.
- Working experience in a fast-paced environment overseeing multiple tasks and supporting multiple teams
- Proven track record of exercising independent thinking, problem solving and achieving goals.
- Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook.
Preferred Qualifications:
- Associate’s and/or Bachelor’s Degree from an accredited institution.
- Knowledge and experience with a traditional and/or omnichannel contact center with emphasis in the healthcare industry.
- Basic knowledge of operational health plan departments and functionality.
- Experience participating in cross-functional projects and departmental initiatives as subject matter expert for customer service.
- Excellent verbal and written communication skills
- Experience working with and basic knowledge of systems such as Interactive Intelligent CIC Suite and Verint 360 Platforms.
- Experience using project tracking, testing and requirement tools (i.e., MS Project, SharePoint, or any other time management system).
- Experience with MS Excel functions that include creating standardized reports, utilizing VLOOKUP’s, pivot tables, filtering, and formulas to generate desired results.
- Ability to multi-task, prioritize, and manage time effectively to accomplish priorities.
Compliance & Regulatory Responsibilities: See Above
License/Certification: N/A
Hiring Range*:
Greater New York City Area (NY, NJ, CT residents): $47,403 - $62,400
All Other Locations (within approved locations): $41,101 - $60,320
As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.
In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.
*The hiring range is defined as the lowest and highest salaries that Healthfirst in “good faith” would pay to a new hire, or for a job promotion, or transfer into this role.