Member Svc. Rep.

CareSource Management Services • New York City, NY

4d

About The Position

Job Summary: Responsible for receiving and handling incoming calls on the general 1-800 numbers and provide first call resolution for members and callers. Directs calls as necessary and/or takes detailed messages if unable to complete request of caller. Provides excellent customer service to all callers/customers and provides requested information as needed. Essential Functions: Answer and handle phone calls and warm transfer only as needed. Assist members with finding providers and setting up appointments. Demonstrate knowledge of eligibility and benefits for all plans. Provide information to callers about our Plans. Write notes for all incoming calls in CaseTrakker Document care management notes captured during member call and works closely with care management team to support member needs. Completes grievance and incident reports. Assist members with calling DME vendors, pharmacy, doctors and other providers as needed to coordinate services. Perform any other job related duties as requested.

Requirements

• High School or GED required
• One (1) year Previous Call Center Experience preferred
• Previous experience working in a healthcare setting preferred
• Fluency (speaking, reading, and writing) in multiple languages as determined by needs of business is required
• Must have experience working in a fast-paced environment.
• Must have exceptional customer service skills, excellent communication skills, attention to detail and possess a good work ethic.
• Proficiency working with computer is necessary.

Nice To Haves

• Associates or Bachelor's degree preferred
• One (1) year Previous Call Center Experience preferred
• Previous experience working in a healthcare setting preferred

Responsibilities

• Answer and handle phone calls and warm transfer only as needed.
• Assist members with finding providers and setting up appointments.
• Demonstrate knowledge of eligibility and benefits for all plans.
• Provide information to callers about our Plans.
• Write notes for all incoming calls in CaseTrakker
• Document care management notes captured during member call and works closely with care management team to support member needs.
• Completes grievance and incident reports.
• Assist members with calling DME vendors, pharmacy, doctors and other providers as needed to coordinate services.
• Perform any other job related duties as requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED