CCO Service Agent

🔥 0 minutes ago

🐊 Florida, New Jersey, +1 more states – Remote

🐊 Florida – Remote 🏖️ New Jersey – Remote 🗽 New York – Remote

💵 $40.2k - $54.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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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

• Support Contact Center Operations by ensuring members and providers receive an exceptional customer experience • Receive and address member and provider inquiries across all Lines of Business • Resolve complaints, educate clients, retain members, help prevent dis-enrollments, and escalate issues requiring additional intervention • Provide customer service regarding eligibility, benefits, claims processes, escalations, and product questions • Handle inbound and outbound calls, emails, and chats • Meet or exceed quality, productivity, and dependability KPIs • Follow policies and procedures to address issues timely and accurately • De-escalate upset members and providers and provide issue resolution • Initiate investigations, participate in root cause analysis, take corrective measures, recommend process improvements, and follow up on outstanding inquiries and complaints • Comply with HIPAA and protect confidential Protected Health Information • Build relationships with internal and external customers through open communication • Work flexible schedules, including late shifts, weekends, holidays, and unforeseen business disruptions • Perform additional duties as required

🎯 Requirements

• High School Diploma or GED from an accredited institution • Prior experience in a customer service environment • Experience participating in cross-functional projects and departmental initiatives related to customer/client interaction and customer service • Working experience in a fast-paced environment • Proficient in Microsoft Office Suite, including Excel, Word, and Outlook • Associate’s or Bachelor’s Degree from an accredited institution or equivalent work experience preferred • Proven independent thinking, problem solving, and goal achievement • Knowledge of traditional and/or omnichannel contact centers, preferably in healthcare • Knowledge of KPIs, CMS/NYSOH requirements, CMS STARS programs, and call center operations • Experience navigating multiple technologies, including a Customer Relationship Management System • Basic knowledge of operational health plan departments and functionality • Working knowledge of Microsoft PowerPoint • Understanding of call center metrics, including Average Handle Time and Quality • Excellent verbal and written communication skills • Ability to document grammatically correct emails, communications, and presentations

🏖️ Benefits

• Medical, dental and vision coverage • Incentive and recognition programs • Life insurance • 401k contributions • Competitive compensation and benefits package