Member Svc. Rep. - Bi-lingual preferred!

CareSource•New York, NY

1d•$41,200 - $66,000

About The Position

The Member Services Representative receives and handles incoming calls on general 1-800 numbers, providing first-call resolution for members and callers. The role provides excellent customer service, shares requested information, directs calls when necessary, and takes detailed messages when a request cannot be completed. The representative helps members find providers and set up appointments, explains plan eligibility and benefits, documents calls and care-management notes in CaseTrakker, and works with the care management team to support member needs. The role also assists with coordinating services through DME vendors, pharmacies, doctors, and other providers, and completes grievance and incident reports.

Requirements

High school diploma or GED.
Fluency in multiple languages, including speaking, reading, and writing, as determined by business needs.
Experience working in a fast-paced environment.
Exceptional customer service skills, excellent communication skills, attention to detail, and a good work ethic.
Proficiency working with a computer.

Nice To Haves

Associate or bachelor's degree.
One year of previous call center experience.
Previous experience working in a healthcare setting.

Responsibilities

Answer and handle phone calls, using warm transfers only as needed.
Assist members with finding providers and setting up appointments.
Demonstrate knowledge of eligibility and benefits for all plans.
Provide callers with information about the plans.
Write notes for all incoming calls in CaseTrakker.
Document care management notes captured during member calls and work closely with the care management team to support member needs.
Complete grievance and incident reports.
Assist members with calling DME vendors, pharmacies, doctors, and other providers as needed to coordinate services.
Perform other job-related duties as requested.