Bilingual Call Center Representative
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Job Description
Bilingual call center representative supporting Healthfirst Medicare Advantage and long-term-care enrollment. Handling member calls, eligibility research, appointment scheduling, and Salesforce documentation remotely.
Responsibilities:
- Handle inbound and outbound customer calls while adhering to internal service-level standards
- Create and follow up on Long-Term Care leads and opportunities in Salesforce for up to 90 days
- Create and follow up on Personal Care service requests for the Mainstream population in Salesforce for up to 30 days
- Answer calls and complete outbound calls according to approved scripts
- Search ePACEs for Medicaid eligibility, exclusion, and exemption codes
- Search Marx (CMS) for Medicare eligibility, enrollments, and special elections
- Achieve daily, weekly, and monthly growth goals
- Handle calls to maximize productivity and operational efficiency
- Connect consumers seeking personal care or long-term care services with the State broker for initial evaluation
- Schedule field and tele-video conference appointments for SHP Intake Nurses, HF CompleteCare Specialists, and Intake Nurses in Salesforce
- Schedule Entitlement Advocates appointments for prospective members with Medicaid coverage issues or restrictions
- Schedule Clinical Assessors to complete Community Health Assessments for Mainstream/HARP members requesting Personal Care Services at home
- Document incoming and outbound calls in Salesforce call tracking
- Document outcomes in the pre-enrollment database system
- Document special instructions in Salesforce
- Coordinate fulfillment kits and brochures for prospective members
- Troubleshoot and follow up on long-term care enrollment rejections
- Work occasional weekends and additional hours before or after scheduled shifts as assigned
- Master the Division’s impact on Healthfirst plans and members
- Establish trust, demonstrate product knowledge and credibility, and maximize scheduled appointments to achieve goals
- Perform additional duties as assigned
Requirements:
- High school diploma or GED
- Fluency in reading and speaking English and Spanish
- Member / Customer Service experience
- Availability to work an 8 ½ hour shift based on business needs, within stated operating hours
- Occasional overtime
- Capability to work in a remote environment with reliable internet connection
- Tech savvy computer skills, including Microsoft Office Suites: Outlook, Excel, Word, PowerPoint
- Organized, able to multitask, and detail oriented
- Understanding of and sensitivity to cultural differences and community needs
- Ability to work in a fast-paced, changing, high-stress environment while achieving quota expectations
- Ability to communicate and engage with leaders via virtual platforms, including email and MS Teams
- Preferred: healthcare industry experience
- Preferred: experience with Medicare or Medicaid managed care plan products
- Preferred: associate degree or higher from an accredited institution
- Preferred: extensive inbound and outbound call center experience with telemarketing responsibilities in healthcare
- Preferred: Healthfirst product knowledge
- Preferred: experience engaging with frail adult or elderly populations
- Preferred: understanding of integrated care
- Preferred: experience in health insurance, home care, acute, sub-acute, long-term care, or managed long-term care
- Preferred: experience managing member information or appointments in a shared network environment using paperless database modules
- Preferred: experience operating in a multicultural work environment and community
- Ability to maintain a calm, neutral disposition while managing many details in a distracting environment
Benefits:
- Medical, dental and vision coverage
- Incentive and recognition programs
- Life insurance
- 401k contributions
- Competitive compensation and benefits package
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