Customer Service Representative II - Canandaigua, NY

Maximus

3d•$18 - $21•Onsite

About The Position

Maximus is seeking a Customer Service Representative II to help New York Medicaid recipients understand healthcare options, access services, and make informed decisions about coverage. The role provides face-to-face and telephone support, including guidance through enrollment, explanations of managed care plan options, and compassionate, people-centered assistance. The position is based onsite at the Maximus office at 3050 County Complex Drive, Canandaigua, NY, and includes two weeks of remote training. The regular schedule is Monday through Friday, 8:00 AM to 4:30 PM. The representative serves as a resource for customer inquiries across phone, interactive voice response (IVR), web portals, and outreach channels. The role supports escalated enrollment cases, responds to complex or sensitive concerns, documents customer interactions, reviews applications and supporting documentation, and educates customers about program offerings, eligibility, enrollment choices, and services. The representative also conducts outreach and enrollment services at LDSS/HRA offices, assists with enrollment changes, collaborates with internal teams and external partners, and maintains an active Certified Application Counselor (CAC) certification. The position requires a high school diploma or GED and at least six months of relevant professional experience, or an equivalent combination of education and experience. Prior customer service, data entry, or data processing experience and familiarity with Microsoft Office applications are required. Some college, New York Medicaid experience, and at least two years in customer service or a related position are preferred. Compensation is listed at $18.00 to $20.50 per hour. Benefits include health and wellness coverage, retirement savings with company matching, paid time off and holidays, disability coverage, tuition reimbursement, and professional development opportunities.

Requirements

High school diploma or GED and at least 6 months of relevant professional experience, or an equivalent combination of education and experience.
Prior work experience in customer service, data entry, and/or data processing.
Experience with Microsoft Office applications, including Excel, PowerPoint, and Word.
Maintain active Certified Application Counselor (CAC) certification.
For two weeks of remote training, have personal computer equipment with Windows 11 or a supported Mac operating system, a private and secure workspace, and reliable high-speed internet.
Internet speed for remote training must be at least 20 Mbps download and 5 Mbps upload; shared internet connectivity requires at least 50 Mbps download.
HP computer users must remove S Mode. Chromebooks and other restricted or low-performing computer platforms cannot access Amazon WorkSpaces.

Nice To Haves

Some college or a college degree.
Experience working with New York Medicaid.
At least 2 years of experience in customer service or a related position.
Ability to follow established guidelines and directions while proactively meeting objectives and deadlines.
Ability to manage multiple tasks and priorities under pressure while maintaining high-quality outcomes in a fast-paced environment.

Responsibilities

Serve as a subject matter resource for inquiries received by telephone, IVR, web portals, and outreach activities regarding program information and services.
Manage and support escalated enrollment cases and processes according to established case-resolution procedures.
Respond to complex or sensitive customer concerns using program policies, procedures, and guidelines to determine appropriate actions or referrals.
Accurately document customer interactions, case activity, outreach efforts, and actions taken in applicable systems.
Navigate multiple systems, tools, and data sources to retrieve, review, compare, analyze, and verify customer or program information.
Conduct outbound contacts to obtain corrections, clarification, or required documentation for case resolution or enrollment verification.
Review and compare customer-submitted documentation, including income or eligibility materials, with application data to verify accuracy and compliance.
Educate customers on program offerings, eligibility requirements, enrollment options, and available services.
Support customers through multiple phases of the application or service lifecycle, from enrollment through receipt of benefits or services.
Identify issues, trends, or barriers affecting customer engagement or service delivery and report them to management or project staff as appropriate.
Collaborate with internal teams, client escalation groups, and external partners to resolve customer issues and support project objectives.
Maintain confidentiality and security of customer, provider, and program information.
Meet or exceed productivity, quality assurance, and performance standards.
Attend required meetings and training and maintain current knowledge of programs, systems, policies, procedures, and compliance requirements.
Conduct face-to-face and/or virtual telephonic outreach and enrollment services, including education on managed care options and public health programs at LDSS/HRA offices.
Assist clients with enrollment, transfer, and disenrollment processes.
Maintain professional and positive relationships with HRA/LDSS county staff and clients.
Assist Call Center Operations and other departments as determined by project management to meet business needs.
Participate as a regular member of an Outreach department processing unit, including EEU, Data Entry, or Manual Notices.
Conduct shadowing and training activities with new hires.
Work on assigned special projects.
Maintain active Certified Application Counselor (CAC) certification and conduct CAC tasks in select counties.
Maintain updated knowledge of the New York Medicaid Choice Project.
Perform other related duties as assigned by management.

Benefits

Comprehensive health and wellness benefits, including medical, dental, vision, prescription coverage, and a partially funded HSA.
Life insurance benefits and discounts on auto, home, renter's, and pet insurance.
401(k) retirement savings plan with company matching.
Paid time off, holidays, and extended sick leave.
Short- and long-term disability coverage.
Employee Assistance Program resources for physical, emotional, and financial wellness.
Performance-based bonuses and other potential incentives or program-specific awards.
Tuition reimbursement.
Employee perks and discounts.
Wellness programs and resources.
Professional development opportunities, including training programs, workshops, and conferences.
Recognition platform for employee contributions.