Healthfirst

The Operations Contact Center Service Agent is responsible for assisting members & providers with issues and inquiries about our members and their insurance, applications and/or claims in one or more families of products, i.e., Medicare, Medicaid. The Service Agent is also responsible for receiving and addressing member & provider inquiries, resolution of complaints, client education, retention of membership and dis-enrollments, and escalation of issues requiring additional intervention.

We are now taking applications for our upcoming Summer Contact Center Agent Class!

 

**This position is eligible for remote work!**

 

Paid Virtual Training: 6 weeks of classroom based training, between the hours of 930am to 530pm, depending on the required shift, Monday through Friday.

 

Work Schedule: Must be available to work any shift between 8am to 8pm including weekends and holidays as needed. This may periodically change to meet business needs.

Salary: 

 

Duties and Responsibilities Include:

• Interacting by phone with providers and members to provide information in response to inquiries, concerns, and questions about insurance coverage and products Healthfirst offers.
• Transferring calls from members and providers to the appropriate department.
• Following-up on inquiries and complaints that have not been resolved.         
• Interacts with customers to provide information in response to inquiries about products and services.           
• Perform research on billing inquires and claims to provide payments and refunds.   
• Acts as a liaison between various departments to address concerns.             
• Identify, research, and resolve customer issues using the computer system.
• Follow-up on customer inquiries not immediately resolved.
• Research member/provider billing and claims issues.
• Research payment and refund issues.
• Handle and resolve customer's complaints.
• Ability to navigate through automated information systems to analyze the caller’s situation.
• Ability to perform in a fast paced, changing environment.
• Speaks in a way the customer can understand.
• Serves as liaison between the customer and various departments.
• Other duties as assigned by the management team related to job functions (sort incoming faxes, correspondence, fax transportation forms, etc.)
• May be required to work some overtime as the business requires.
• May be required to work flexible schedules (nights, weekends), or change schedules as it is determined necessary based on the needs of the business, which are subject to change.
• Demonstrates the ability to perform in a highly metric driven environment, maintaining minimum quality scores or better.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.