Bilingual Call Center Representative

HF Management Services•New York City, LA

3d•Remote

About The Position

The Relationship Coordinator solicits and provides information via telephone in support of Healthfirst’s Medicare Advantage Plan, Complete Care (MAP), Managed Long Term Care Plan (MLTC) Senior Health Partners (SHP), and Mainstream/Health and Recovery Plan (HARP) population seeking PCA and/or CDPAS services. The role courteously educates referral sources, prospective enrollees, and family members about Long-Term Care enrollment, communicates and follows up with them, and clearly explains each product line. The coordinator connects these activities to Healthfirst’s sales goals and meets established quotas. The Integrated Products team works in a paperless call center environment. The position involves daily administration of electronic Patient Health Information (PHI) databases and security tools such as encryption. Systems include Salesforce, RightFax, virtual work platforms using VPN, SharePoint sites, TruCare, and Microsoft Office 365, including Word and Outlook. The position requires an 8½-hour shift scheduled according to business needs. Regular operating hours are Monday through Friday, 8:00 AM–8:00 PM, and Saturday, 10:00 AM–6:30 PM. During open enrollment (October–March), operating hours are 8:00 AM–8:00 PM Monday through Sunday. Initial training hours may differ from the permanent schedule. Occasional overtime and occasional weekend work may be needed. The role can be performed remotely with a reliable internet connection. Hiring ranges are $48,600–$65,960 for residents of the Greater New York City Area (NY, NJ, CT), and $42,200–$62,400 for other approved locations. Salary and related compensation depend on work experience, education, licenses, certifications, and other factors Healthfirst considers pertinent. Benefits include medical, dental, and vision coverage, incentive and recognition programs, life insurance, and 401(k) contributions, subject to eligibility requirements.

Requirements

High school diploma or GED.
Fluency in reading and speaking English and Spanish.
Member or customer service experience.
Availability to work an 8½-hour shift within the stated business hours, which may include weekends during open enrollment.
Occasional overtime availability.
Ability to work remotely with a reliable internet connection.
Computer skills, including Microsoft Office applications such as Outlook, Excel, Word, and PowerPoint.
Organized, detail-oriented, and able to multitask.
Understanding of and sensitivity to cultural differences and the needs of the community.
Ability to work amid fast-changing priorities and high stress while meeting quota expectations.
Availability to communicate and engage with leaders through virtual platforms, email, MS Teams, and other tools.

Nice To Haves

Healthcare industry work experience.
Experience with Medicare or Medicaid managed-care products such as Family Health Plus (FHP), Eastern Benefits System (EBS), or Federal Employee Program (FEP).
Associate degree or higher from an accredited institution.
Extensive healthcare call-center experience with inbound and outbound calls and telemarketing responsibilities.
Knowledge of Healthfirst Complete Care, Senior Health Partners (SHP), or managed long-term care products.
Prior experience engaging or communicating with frail adults or elderly people.
Understanding of the value of integrated care.
Experience in health insurance, home care, acute, sub-acute, long-term-care, or managed-long-term-care settings.
Experience managing member information or appointments in a shared network environment using paperless database modules.
Ability to work in a multicultural environment and community, including with Spanish, Chinese, Southeast Asian, and other members.
Ability to maintain a calm, neutral disposition while managing many details in a distracting environment.

Responsibilities

Handle inbound and outbound customer calls, address callers’ needs, and meet internal service-level standards.
Create and follow up for up to 90 days on Long-Term Care leads and opportunities entered in Salesforce.
Create and follow up for up to 30 days on Mainstream population personal-care service requests in Salesforce.
Answer calls or make outbound calls using 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 handle calls to maximize productivity and operational efficiency.
Connect consumers seeking personal-care or long-term-care services with the State broker for an initial evaluation.
Schedule field and tele-video appointments in Salesforce for SHP Intake Nurses and HF CompleteCare Specialists and Intake Nurses.
Schedule Entitlement Advocate appointments for SHP and HF Complete Care prospective members with Medicaid coverage issues or restrictions.
Schedule Clinical Assessors to complete Community Health Assessments for Mainstream/HARP members requesting in-home Personal Care Services.
Document incoming and outbound calls in Salesforce call tracking, record outcomes in the pre-enrollment database, and document special instructions in Salesforce.
Coordinate timely preparation of fulfillment kits and brochures for prospective members or people requesting additional information.
Troubleshoot and follow up on Long-Term Care enrollment rejections.
Build knowledge of the division’s impact on Healthfirst plans and members.
Create a positive first impression, demonstrate product knowledge and credibility, establish trust, and maximize scheduled appointments to meet goals.
Perform other duties as assigned.