Member Svc. Rep. - Bi-lingual preferred!

CareSource Management Services LLC; New York (NY); On-site; USD 41,000 - 66,000; Full time

Job summary

CareSource is seeking a Member Services Representative to handle incoming calls on the 1-800 numbers and provide first-call resolution. You will assist members with finding providers, setting up appointments, and explaining plan eligibility and benefits.

Documentation of calls and collaboration with the care management team are essential parts of the role. The role requires high school or GED, with preferred associates or bachelor's degree, and at least one year in a call center or healthcare

Qualifications

• Fluency in multiple languages required as per business needs.
• Excellent customer service and communication skills essential.
• Strong attention to detail and reliable work ethic.

Responsibilities

• Answer inbound calls and perform warm transfers when needed.
• Assist members with finding providers and setting up appointments.
• Explain eligibility and benefits for all plans; document care notes.
• Coordinate with care management and assist with calling providers as required.
• Complete grievances and incident reports as necessary.

Skills

Multilingual fluency

Customer service

Communication skills

Attention to detail

Computer proficiency

Education

High School or GED

Associates 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

Equal Opportunity Statement

CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time.

Brand

#LI-JS2 Brand=ElderServe

The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference‑makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer‑centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.