Bilingual Call Center Representative

healthfirst; United States; Remote; USD 42,000 - 68,000; Full time

Job summary

Healthfirst is seeking a Relationship Coordinator to support Medicare Advantage and related programs. The role involves educating referral sources and prospective enrollees on LTC enrollment, managing calls, and scheduling visits for SHP intake nurses and specialists.

You will work in a paperless, security-conscious environment using Salesforce and MS Office tools. The candidate should be fluent in English and Spanish, have prior customer service experience, and be able to meet daily and monthly

Qualifications

• High school diploma or GED.
• Fluent in reading and speaking English and Spanish.
• Customer service experience.
• Ability to work flexible hours, including weekends during enrollment periods.

Responsibilities

• Handle inbound and outbound calls to address customer needs while meeting SLAs.
• Create and follow up for LTC Leads and opportunities in Salesforce.
• Coordinate appointments and correspondence for SHP intake and CompleteCare teams.
• Document outcomes in Salesforce and pre-enrollment systems.
• Assist with enrollment processes and coordinate with state brokers as needed.
• Promote product knowledge to educate prospective members and drive appointments.

Skills

Bilingual English & Spanish

Customer service experience

Sales orientation

CRM systems (Salesforce)

Education

High school diploma or GED

Tools

Salesforce

MS Office (Outlook, Excel, Word)

Job description

The Relationship Coordinator solicits and provides information via telephonic efforts in support of Healthfirst's Medicare Advantage Plan, Complete Care (MAP), Managed Long Term Care Plan (MLTC) Senior Health Partners (SHP) and Mainstream/Health and Recovery Plan (HARP) population seeking PCA and/or CDPAS services. This position ensures that referral sources, prospective enrollees and/or family members are courteously, appropriately, and effectively educated on the Long-Term Care enrollment processed through communication and follow-up and clearly articulate each product line to prospective clients. In addition, the Relationship Coordinator understands how Healthfirst goals relate to sales performance and meet established quotas. Integrated Products is a paperless, call center work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include, but are not limited to, Salesforce, RightFax, Virtual Work Platforms (using VPN), SharePoint Sites, TruCare and MS Office 365 software (such as Word and Outlook).

Duties and Responsibilities

• Handling inbound and outbound calls to and from customers to address their needs while adhering to internal Service Levels standards.
• Creates and/or follow ups for up to 90 days on Long-Term Care (LTC) Leads and Opportunities entered in Salesforce.
• Create and/or follow ups for up to 30 days on Personal Care services requests for the Mainstream population in Salesforce.
• Answer all calls or complete outbound calls according to approved scripts.
• Searches ePACEs for Medicaid eligibility, exclusion, and exemption codes.
• Searches in Marx (CMS) for Medicare eligibility, enrollments, and special elections.
• Achieves daily, weekly, and monthly growth goals.
• Handle all calls to maximize productivity and optimal operational efficiency.
• Connects consumers seeking personal care/long term care services with the State broker to complete the initial evaluation.
• Schedules all field and tele video conference appointments for SHP Intake Nurses in Salesforce.
• Schedules all field and tele video conference appointments for HF CompleteCare Specialist and Intake Nurses in Salesforce.
• Schedules Entitlement Advocates appointments for SHP and HF Complete Care prospective members with a Medicaid coverage issue or restriction.
• Schedules Clinical Assessors to complete Community Health Assessments for Mainstream/HARP members requesting Personal Care Services at home.
• Documents all incoming/outbound calls under call tracking in Salesforce
• Documents all outcomes in pre-enrollment database system.
• Documents all special instructions in Salesforce
• Coordinates the preparation of fulfillment kits / brochures to prospective members or those requesting addition information in a timely manner.
• Troubleshoots and follows up on LTC enrollment rejections.
• Handles other duties as assigned with the occasional need to work weekends, additional hours before or after shift scheduled.
• Engage in mastering the Divisions impact on all Healthfirst Plans and its members.
• Ability to create a positive impression during first contact with prospective members by setting the tone and being able to immediately demonstrate product knowledge and credibility with the goal of maximizing the number of scheduled appointments to achieve daily, weekly, and monthly goals. Persuasive and able to establish trust.
• Additional duties as assigned.

Minimum Qualifications

• High school diploma or GED.
• Fluency in reading and speaking English and Spanish
• Member / Customer Service experience.
• Availability to work for 8 ½ hours shift, based on business needs, within our hours of operations: Monday - Friday 8:00 AM - 8:00 PM and Saturdays 10:00 AM - 6:30 PM. 8:00 AM to 8:00 PM Monday -Sunday during open enrollment (October - March). Initial Training schedule may vary from permanent assigned schedule.
• Occasional overtime.
• Capability to work in a remote environment with reliable internet connection.
• Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint
• Organized and multi-tasking capabilities and detail oriented.
• Understanding of and sensitivity to cultural differences and needs of the community are essential.
• Adept at working in an environment with fast-past changing priorities including high stress while achieving quota expectations.
• Available to communicate / engage with your leaders via Virtual platforms (emails, MS Teams and others)

Preferred Qualifications

• Work experience within the healthcare industry
• Experience with Medicare or Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS) and/or Federal Employee Program (FEP). (Preferred)
• Associate degree or higher from an accredited institution.
• Extensive work experience including inbound and outbound call center with telemarketing responsibilities within a healthcare environment.
• Healthfirst product