Field Service Agent - Queens - Bengali/Urdu

HF Management Services•New York City, NY

3d•Onsite

About The Position

The Field Service Agent acts as an in-person liaison between Healthfirst and its customers, assisting members and providers with inquiries and issues across all Lines of Business. The role involves addressing questions, de-escalating and resolving complaints, educating clients, supporting member retention, and escalating matters that require additional intervention through face-to-face, telephonic, and/or omnichannel contact center interactions. The agent helps maintain Healthfirst’s customer-focused culture and improve the customer experience, including First Encounter Resolution and Customer Experience measures for members and providers. The position serves customers on topics such as eligibility, benefits, claims processes, escalations, and products. It also includes participation in community events, campaigns, case reviews, investigations, root-cause analysis, and Contact Center Operations outbound campaigns. The agent must protect confidential information and comply with HIPAA and applicable regulatory requirements. Weekend responsibilities may be required periodically, and the role requires flexibility to accommodate business needs, including nights, weekends, holidays, alternate locations, and overtime with limited notice.

Requirements

High school diploma or GED equivalent from an accredited institution.
Experience in a customer service environment.
Experience handling escalated issues and complex situations requiring conflict resolution, active listening, and empathy.
Experience working in a fast-paced environment while handling multiple priorities simultaneously.
Willingness to accommodate flexible business needs, including nights, weekends, holidays, alternate locations, and/or overtime with limited notice.
Work experience using Microsoft Office Suite applications, including Excel, Word, and Outlook.
Work experience requiring effective verbal and written communication, with good grammar, spelling, and punctuation.

Nice To Haves

Associate degree from an accredited institution or equivalent work experience.
English proficiency and bilingual ability in Bengali and/or Urdu.
Basic knowledge of operational health plan departments and their functions.
Knowledge and experience with traditional and/or omnichannel contact centers, particularly in healthcare, including familiarity with KPIs, CMS/NYSOH requirements (including CMS STARS programs), and general call center operations.
Training in multiple Healthfirst Lines of Business for both Member and Provider Families of Products.

Responsibilities

Provide high-quality customer service to members and providers across all Lines of Business on topics including eligibility, benefits, claims processes, escalations, and products.
Manage face-to-face customer encounters, answer inquiries about products and services, improve the member experience, reduce waiting time, and expedite traffic flow.
Identify and de-escalate dissatisfied member or provider situations and provide satisfactory resolutions.
Build trusted relationships through open and interactive communication with internal and external customers.
Provide ad hoc assistance to cross-functional teams working on campaigns and case reviews to help ensure standards are met.
Participate in community events with other Healthfirst member-facing departments to engage and educate existing and prospective members.
Comply with HIPAA requirements, protect confidential member, provider, medical, and departmental information, and follow applicable local, state, federal, and Healthfirst compliance and regulatory guidelines.
Assist periodically with weekend responsibilities at Healthfirst Community Offices or other events.
Initiate investigations, participate with assigned parties in root-cause analysis, communicate complex information, take or recommend proactive and corrective measures and process improvements, and follow up on outstanding inquiries and complaints within defined timeframes.
Assist Contact Center Operations outbound campaigns on high-volume days while meeting individual and team deliverables.
Perform additional duties as assigned.