Field Service Agent - Long Island - Spanish

HealthFirst•Holtsville, NY

1d•$42,200 - $65,960•Onsite

About The Position

The Field Service Agent acts as an in-person liaison between Healthfirst and its customers. The role receives and addresses member and provider inquiries, de-escalates and resolves complaints, educates clients, supports member retention, and escalates issues requiring additional intervention across all Lines of Business. Work may take place face-to-face, by telephone, and/or in an omnichannel contact center environment. The agent maintains Healthfirst’s culture and helps improve customer experience, as measured by First Encounter Resolution and Customer Experience measures, for members and providers. The position provides customer service on topics including eligibility, benefits, claims, escalations, and products; manages in-person encounters to improve the member experience and reduce wait times; and builds trusting relationships through open communication. It also supports campaigns and case reviews, participates in community events, complies with privacy and regulatory requirements, investigates and follows up on complaints, and assists with outbound contact-center campaigns. Periodic weekend work and flexibility to meet business needs, including nights, weekends, holidays, alternate locations, and overtime with limited notice, are required.

Requirements

High school diploma or GED equivalent from an accredited institution.
Experience in a customer service environment.
Experience handling escalated issues, complex situations, and interactions 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 with 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.
Ability to exercise independent thinking, solve problems, and achieve goals.
English proficiency and fluency in Spanish.
Basic knowledge of operational health plan departments and their functions.
Knowledge and experience with a traditional and/or omnichannel contact center, preferably in healthcare, including KPIs, CMS/NYSOH requirements (including CMS STARS programs), and 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 providers and members across all Lines of Business on questions and issues involving eligibility, benefits, claims processes, escalations, and products.
Manage face-to-face encounters by providing information about products and services, improving the member experience, reducing wait times, and expediting traffic flow.
Identify and de-escalate dissatisfied member or provider situations and provide satisfactory resolutions.
Build sustainable relationships of trust 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 ensure standards are met.
Partner with other member-facing departments and participate in community events to engage and educate existing and prospective members.
Comply with HIPAA requirements, protect the confidentiality of Protected Health Information, and adhere to 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 customer inquiries and complaints within defined timeframes.
Assist Contact Center Operations with outbound campaigns on high-volume days while meeting individual and team deliverables.
Perform additional duties as assigned.