Bilingual Member Services Representative
About The Position
Amida Care, the largest Medicaid HIV Special Needs Plan in NY, delivers a uniquely effective care model that has become a true benchmark for innovation, engagement and member health outcomes. Our mission is to provide access to comprehensive care and coordinated services that facilitate positive health outcomes and general well-being for our members. This true integrative care model addresses psychosocial, housing, behavioral and medical services directly evolving around the needs of each member. We are a community of individuals from diverse peoples who work together to actively foster a fair, equitable, inclusive environment where all employees receive an invitation to belong. We are actively seeking a highly motivated, innovative and experienced individual to join our team as the Bilingual Member Services Representative. Compensation will be commensurate with experience.
Requirements
- Strong verbal and written communication skills in English and Spanish.
- Minimum one (1) years’ experience in Customer Service.
- Must be able to maintain strict confidentiality of sensitive member’s information (HIPAA).
- Proficiency in Microsoft Office (Word, Excel).
- Ability to sit for an extended period.
- Ability to manage multiple tasks and work consistently in a fast-paced environment.
- Understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts in accordance with the organization’s vision, mission, and values.
Responsibilities
- Answer members and providers’ inquiries concerning plan benefits, claims and complaints.
- Escalate complex and urgent member care needs to the appropriate Management or departments.
- Transfer members to Amida Care’s Partners for Services provided on behalf of Amida Care.
- Navigate different systems and databases to resolve members’ issues or concerns.
- Document all conversations/touchpoints in the Amida Care system (Salesforce).
- Meet Quality Assurance requirements and other call center key performance metrics.
- Collect and document prospective members information the Amida Care system (Salesforce).
- Conduct outbound calls for projects and member outreach follow–ups.
- Confirm and update member contact information and demographic, such as address, phone numbers & Primary Care Provider etc.
- Promote and educate members on plan benefits, services, programs, alerts, and reminders.
- Conduct New Member Orientation as assigned.
- Utilize translation line as needed to communicate with members.
- Attend events as needed: Town Hall Meetings, Live Your Life (LYL) Events, NML (New Member Luncheon).
- Provide feedback to management teams on any trending member inquiries and/ or activities for process improvement.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
