Field Service Agent - Manhattan - Spanish

Healthfirst; New York (NY); On-site; USD 49,000 - 66,000; Full time

Benefits offered by this job

Medical, Dental, Vision coverage

401k contributions

Job summary

Healthfirst in New York is seeking a Field Service Agent to serve as the in-person liaison between Healthfirst and its customers. You will handle inquiries about insurance, applications and/or claims, while ensuring HIPAA compliance and protecting PHI. Role requires flexible hours and weekend coverage in line with business needs.

The position emphasizes high-quality face-to-face service, de-escalation skills, and cross-functional collaboration to improve member experience and retention.

Qualifications

• Minimum High School diploma or GED required.
• Experience in a customer service environment is essential.
• Ability to handle escalated issues with empathy and clarity.
• Strong written and verbal communication skills.

Responsibilities

• Provide high-quality customer service to providers and members across all LOBs with a variety of questions and issues.
• Manage face-to-face encounters to improve member experience and reduce wait times.
• Identify and de-escalate situations to provide satisfactory resolutions.
• Build trust through open and interactive communication with customers.
• Assist cross-functional teams on campaigns and case reviews to meet standards.
• Partner with Healthfirst departments by participating in community events for member education.
• Comply with HIPAA and protect PHI; follow regulatory guidelines.
• Assist with weekend responsibilities at Healthfirst Community Offices or events.
• Initiate investigations and contribute to root cause analyses for process improvements.
• Support Contact Center Operations outbound campaigns during high-volume days.

Skills

Customer Service

Active Listening

Empathy

Conflict Resolution

Communication

Multitasking

Flexibility

Education

High School Diploma or GED

Tools

Microsoft Office Suite

Job description

The Field Service Agent acts as an in-person liaison between Healthfirst and its customers. The individual is responsible for assisting customers with issues and inquiries they may have about their insurance, applications and/or claims not paid. The Field Service Agent is also responsible for receiving and addressing member inquiries, resolution of customer complaints, client education, retention of membership and dis-enrollments.

Job Description

Duties/Responsibilities

• Provide high-quality customer service to providers and members across all LOBs with a variety of questions and issues on topics such as eligibility, benefits, claims process, escalations, and products
• Manage face-to-face encounters by interacting with customers to provide information in response to inquiries about products and services, improve overall member experience, and reduce waiting time to expedite traffic flow
• Identify and de-escalate situations where member/provider is dissatisfied and provide a satisfactory resolution
• Build sustainable relationships of trust through open and interactive communication with internal and external customers
• Provide ad-hoc assistance to cross functional teams working on campaigns and case reviews to ensure standards are met
• Partner with other Healthfirst member-facing departments by participating in community events to engage and educate existing/prospective members
• Comply with HIPAA requirements and maintain Protected Health Information (PHI) confidentiality of member, provider, medical and departmental information; adhere to local, state, federal and Healthfirst specific compliance and regulatory guidelines
• Assist periodically with weekend responsibilities at Healthfirst Community Offices (CO) or other events
• Initiate investigations, partner with other assigned parties to participate in root cause analysis, communicate complex information, take proactive and/or corrective measures and/or recommend solutions and methods for process improvement and follow-up on outstanding customer inquiries and complaints within defined timeframes
• Assist with Contact Center Operations (CCO) outbound campaigns on high volume days, while meeting deliverables associated with individual and team accountabilities
• Additional duties as assigned

Minimum Qualifications

• High School Diploma or GED equivalent from an accredited institution
• Experience in a customer service environment
• Experience handling escalated issues, complex situations, and interactions requiring conflict resolution, active listening skills, and empathy
• Experience working in a fast-paced environment that requires handling multiple priorities simultaneously
• Willing to accommodate flexible business needs (Ex: nights, weekends, holidays, alternate locations, and/or overtime with limited notice)
• Work experience with Microsoft Office Suite applications including Excel, Word, and Outlook
• Work experience requiring effective communication verbally and in writing while demonstrating good grammar, spelling, and punctuation skills

Preferred Qualifications

• Associate degree from an accredited institution or equivalent work experience
• Ability to exercise independent thinking, problem solving and achieving goals
• English proficient bilingual who also speaks Spanish
• Basic knowledge of operational health plan departments and functionality
• Knowledge and experience with a traditional and/or omnichannel contact center with emphasis in the healthcare industry, may include but not limited to KPIs, CMS/NYSOH requirements (including CMS STARS programs) and call center operations in general
• Trained in multiple Healthfirst LOBs for both Member and Provider Family of Products (FOPs)

Compliance & Regulatory Responsibilities

See Above License/Certification: N/A

Hiring Range

• Greater New York City Area (NY, NJ, CT residents): $48,600 - $65,960
• All Other Locations (within approved locations): $42,200 - $62,400

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.