Bilingual Call Center Representative – Relationship Coordinator

🕒 June 16

🦌 Connecticut, New Jersey, +1 more states – Remote

🦌 Connecticut – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote

💵 $42.2k - $66k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

📞 Call Center Representative

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Healthfirst

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1993

🛡️ Insurance

🏥 Healthcare

⚕️ Healthcare Insurance

Insurance • Healthcare • Healthcare Insurance

Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.

📋 Description

• 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 services 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 and maximize productivity • 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 and Healthfirst CompleteCare nurses and specialists in Salesforce • Schedule Entitlement Advocates appointments for prospective SHP and HF Complete Care members with Medicaid coverage issues or restrictions • Schedule Clinical Assessors for Community Health Assessments for Mainstream/HARP members requesting in-home Personal Care Services • Document incoming and outbound calls, outcomes, and special instructions in Salesforce and pre-enrollment databases • Coordinate fulfillment kits and brochures for prospective members • Troubleshoot and follow up on Long-Term Care enrollment rejections • Build product knowledge across Healthfirst plans and members • Create a positive first impression, establish trust, educate prospective members, and maximize scheduled appointments to meet quotas • Perform other duties as assigned, including occasional weekends and additional hours

🎯 Requirements

• High school diploma or GED • Fluency in reading and speaking English and an additional language • Member/customer service experience • Availability for an 8½-hour shift within operating hours, including Monday–Saturday schedules • Availability for 8:00 AM–8:00 PM Monday–Sunday during open enrollment from October through March • Occasional overtime availability • Ability to work remotely with a reliable internet connection • Tech-savvy computer skills, including Microsoft Office Suite, Outlook, Excel, Word, and PowerPoint • Organized, detail-oriented, and able to multitask • Understanding of and sensitivity to cultural differences and community needs • Ability to work amid fast-paced, changing priorities and high stress while achieving quotas • Ability to communicate with leaders through virtual platforms such as email and MS Teams • 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 healthcare call-center and telemarketing experience preferred • Healthfirst product knowledge preferred • Experience communicating with frail adults 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 settings preferred • Experience managing member information or appointments in shared-network, paperless database environments preferred • Ability to operate in a multicultural work environment and community preferred • Ability to maintain a calm, neutral disposition while managing many details in a distracting environment preferred • License/Certification: N/A

🏖️ Benefits

• Medical coverage • Dental coverage • Vision coverage • Incentive and recognition programs • Life insurance • 401k contributions (all benefits are subject to eligibility requirements) • Remote work environment • Equal opportunity employment • Reasonable accommodation for applicants with disabilities