Remote Eligibility Specialist - Bilingual & Multichannel

brightonhealthplansolutions; New York (NY); On-site; USD 43,000 - 50,000; Full time

Job summary

Brighton Health Plan Solutions, LLC, is seeking an Eligibility Service Representative (ESR) experienced in eligibility processes across phone, chat and email. The ESR will confirm, research and resolve eligibility and coverage changes while supporting the Eligibility & Benefits team.

The role requires bilingual Russian/English or Korean/English, remote work capability, and high-volume enrollment experience. Training from 9AM to 6PM EST with alternate schedules is available.

Qualifications

• Bilingual in Russian/English or Korean/English.
• Flexible availability for alternate schedules/hours, including shifts between 11AM and 9PM EST, Monday through Friday, with training from 9AM to 6PM.
• Experience in high-volume enrollment and eligibility transactions, premium billing, and collections.
• Knowledge of labor and commercial carrier enrollment procedures.
• Prior high-volume call center experience.
• General knowledge of HIPAA Confidentiality.
• Remote work capability with internet access.
• Some college or business school education is advantageous.

Responsibilities

• The ESR will be responsible for receiving and resolving caregiver inquiries.
• Works with the Benefits Enrollment team to review and resolve any eligibility, hours or co-premium issues including follow-up outreach to caregivers.
• Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions.
• Demonstrate strong customer service skills,attention to detail, research & analyzation and issue resolution.
• Clarify customer requirements; probe for and confirm understanding of requirements or problem.
• Agent will be responsible for managing caregiver requests within required turnaround time including conducting outreach to internal partners, engaging the support of the Team Leader and Supervisor as necessary.
• Communicate effectively with individuals/teams to ensure high quality and timely expedition of customer requests.
• Participate in activities designed to improve customer satisfaction and business performance.
• Use decision-support tools to answer questions, where needed.
• Ability to use critical thinking to solve complex problems and identify when to elevate to the appropriate department.
• Performs call center functions including handling inbound calls and support projects as directed by the management.
• Maintain broad knowledge of client requirements, procedures and key contacts.
• Support projects and other departments in completing tasks when directed by management.

Skills

Multichannel communication

Bilingual proficiency

Education

High School diploma or GED

Some college or business school education advantageous

Tools

Microsoft Office

Job description

Brighton Health Plan Solutions, LLC, is seeking an Eligibility Service Representative (ESR) experienced in eligibility processes across phone, chat and email. The ESR will confirm, research and resolve eligibility and coverage changes while supporting the Eligibility & Benefits team.

The role requires bilingual Russian/English or Korean/English, remote work capability, and high-volume enrollment experience. Training from 9AM to 6PM EST with alternate schedules is available.