Summary:

Handle incoming inquiries through multiple contact channels for our CNY HMO members. Effectively and efficiently communicate resolutions to member’s requests ensuring high First Contact Resolution rates. Advocate for our members in the event there are issues and follow up with the members once the issues are resolved.

Responsibilities:

Create a connection and develop rapport with members to provide outstanding personalized service. Identify customer needs and assist in providing complete resolution of customer concerns including claims, benefit and enrollment inquiries through health plan navigation and collaboration with other internal groups. Serve as an expert in EmblemHealth products, services and technology platforms. Champion efforts to solve the members request on the initial call; provide follow up if not solved on the initial call. Inform and educate members on how to utilize self service capabilities and functionality with the portals and mobile application. Act as a scheduling agent, working in collaboration with the member, to ensure appointments are scheduled, as necessary. Proactively provide information and recommendations to maximize the customer experience: gather and provide feedback to stakeholders based on member feedback to further improve customer experience.

Requirements:

Bachelors’ degree required; additional experience/specialized training may be considered in lieu of educational requirements 1-2+ years of relevant, professional work experience required Healthcare experience including pharmacy background preferred Proficient with MS Office (Word, Excel, PowerPoint, Teams, Outlook, etc.) required Strong customer service skills and the ability to empathize with the customer’s perspective required Knowledge of health insurance industry required Strong communication skills (verbal, written, presentation, interpersonal) with all types/levels of audience required Ability to clearly and effectively convey information and concepts to customers required Dependability and adaptability required Commitment to quality and continuous improvement required Strong problem-solving skills to be applied to a wider array of business challenges required High level of proficiency all applicable systems and process required Additional Information Requisition ID: 24056 Hiring Range: $19.23/per hour