Member Service Representative - Bronx

CareSource; New York (NY); On-site; USD 56,757,000 - 90,922,000; Full time

Job summary

CareSource is seeking a Member Services Representative to handle incoming calls on the general 1-800 numbers, delivering first-call resolution and courteous service to members and callers.

You will assist members with finding providers and setting up appointments, demonstrate knowledge of eligibility and benefits for all plans, and document calls in CaseTrakker. This is a healthcare environment requiring strong communication and computer skills.

Qualifications

• Fluency in multiple languages as required by business needs.
• Experience delivering excellent customer service in a fast-paced environment.
• Strong communication skills and attention to detail; proficient with computers.

Responsibilities

• Answer and handle phone calls; perform warm transfers as needed.
• Assist members with finding providers and setting up appointments.
• Explain eligibility and benefits for all plans.
• Provide information about plans to callers.
• Write notes for all calls in CaseTrakker.
• Document care management notes and support member needs.
• Complete grievance and incident reports.
• Assist members with coordinating services with DME vendors, pharmacy, doctors, and other providers.

Skills

Multilingual

Customer service

Communication skills

Attention to detail

Computer proficiency

Education

High School diploma or GED

Associate or Bachelor’s degree preferred

Job description

Job Summary:

The Member Services Representative is responsible for receiving and handling incoming calls on the general 1-800 numbers and provide first call resolution for members and callers. Directs calls as necessary and/or takes detailed messages if unable to complete request of caller. Provides excellent customer service to all callers/customers and provides requested information as needed.

Essential Functions:

• Answer and handle phone calls and warm transfer only as needed.
• Assist members with finding providers and setting up appointments.
• Demonstrate knowledge of eligibility and benefits for all plans.
• Provide information to callers about our Plans.
• Write notes for all incoming calls in CaseTrakker
• Document care management notes captured during member call and works closely with care management team to support member needs.
• Completes grievance and incident reports.
• Assist members with calling DME vendors, pharmacy, doctors and other providers as needed to coordinate services.
• Perform any other job related duties as requested.

Education and Experience:

• High School or GED required
• Associates or Bachelor’s degree preferred
• One (1) year Previous Call Center Experience preferred
• Previous experience working in a healthcare setting preferred

Competencies, Knowledge and Skills:

• Fluency (speaking, reading, and writing) in multiple languages as determined by needs of business is required
• Must have experience working in a fast-paced environment.
• Must have exceptional customer service skills, excellent communication skills, attention to detail and possess a good work ethic.
• Proficiency working with computer is necessary.

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time
• Travel is not typically required

Compensation Range:

$41,200.00 - $66,000.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Hourly

Organization Level Competencies

• Fostering a Collaborative Workplace Culture
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

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