Bilingual Customer Service Rep - Home Office, United States - HealthFirst

Description

The Bilingual (Man/Can or Spanish) Relationship Coordinator Inbound solicits and provides information via telephonic efforts in support of Healthfirst's Medicare Advantage Plan (MAP) and Senior Health Partners' (SHP) Managed Long-Term Care Plan (MLTCP). This position ensures that referral sources, prospective enrollees and/or significant others are courteously, appropriately and effectively processed through communication and follow-up with all relevant parties. Understands how Healthfirst's goals relate to sales performance and meet established quotas. Ability to clearly articulate each product line to prospective clients is critical. SHP is a paperless work environment requiring daily hands-on administration of multiple electronic Patient Health Information (PHI) databases and security requirement tools such as encryption. These systems include, but are not limited to, CCMS (CareEnhance Clinical Management Software), Sunguard Macess Service Module (electronic archiving), RightFax, VoIP, Virtual Work Platforms (using VPN), scanning and creating .pdf files (Adobe Acrobat), and MS Office 2010 software (such as Word and Outlook).

• Ability to multitask and remain focused in an environment with distractions.
• Receives and screens all incoming SHP calls and handles Maximus ""warm transfer calls"".
• Enters all referrals into pre-enrollment database system.
• Transfers all incoming calls to appropriate staff, unit or department.
• Assist callers requesting enrollment application status information by transferring to appropriate staff as needed.
• Calls prospective SHP clients according to approved scripts within 24 hours.
• Searches ePACEs for Medicaid eligibility, exclusion, and exemption codes.
• Documents all client calls and outcomes in pre-enrollment database system.
• Achieves daily, weekly and monthly goals for outbound telemarketing calls and booking appointments.
• Calls prospective Healthfirst CompleteCare clients according to Centers for Medicare & Medicaid Services (CMS) approved scripts within 24 hours.
• Searches ePACES for Medicaid and Medicare eligibility, exclusion and exemption codes.
• Achieves daily, weekly and monthly goals for outbound telemarketing calls and booking appointments.
• Schedules all field appointments for SHP Enrollment Specialists and Intake Nurses in Electronic Medical Records database (EMR
• Documents all special instructions in EMR schedule notes.
• Documents all client replies in EMR 1st-5th Contact milestones.
• Schedules field appointments for Healthfirst CompleteCare Specialist and Intake Nurses in EMR within 48 hours' referral receipt while maximizing joint visits (Specialist + Nurse).
• Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects.
• Follow protocols and use common sense to escalate situations to management and clinical staff appropriately.
• Handle other duties as assigned with the occasional need to work weekends, additional hours before or after shift schedule and from other Healthfirst site locations.
• Supporting Relationship Coordinator outbound callers as needed.
• Engage in mastering the Divisions impact on Healthfirst, SHP and its Members.
• Additional duties as assigned

Minimum Qualifications:

• Fluency in reading and speaking English and additional language.
• Inbound and outbound call center work experience with telemarketing responsibilities.
• Work experience within the healthcare industry.
• A solid commitment to improving care for frail adults.
• Experience with Medicare or Medicaid managed care plan products such as, Family Health Plus (FHP), Eastern Benefits System (EBS) and/or Federal Employee Program (FEP).
• Work schedule 11:30am-8:00pm M-F; Initial training for approx. 1 month is 9:00-5:30pm M-F.
• Occasional overtime with potential for occasional weekends.
• High school diploma or GED.

Preferred Qualifications:

• Associate's degree or higher from an accredited institution.
• Extensive work experience including inbound and outbound call center with telemarketing responsibilities within a healthcare environment.
• Healthfirst product knowledge of CompleteCare, Senior Health Partners (SHP) or managed long-term care.
• Prior experience working with the frail adult or elderly population.
• A solid understanding of the value of integrated care.
• Experience in health insurance, home care environment, acute, sub-acute, long-term care (LTC) setting or managed-long term care (MLTCP).
• Experience managing member information or appointments in a shared network environment using paperless database modules.
• Ability to create a positive impression during first contact with prospective members by setting the tone and being able to immediately demonstrate product knowledge and credibility with the goal of maximizing the number of scheduled appointments to achieve daily, weekly, and monthly goals. Persuasive and able to establish trust.
• Accurate typing skills including excellent written communication and the ability to document grammatically correct notes.
• Understanding of and sensitivity to cultural differences and needs of the community are essential.
• Adept at operating within a diverse and multi-cultural work environment and community of Members such as Spanish, Chinese, Russian, Creole and Korean.
• Adept at working in an environment with fast-past changing priorities including high stress while achieving quota expectations.
• Ability to maintain a calm, neutral disposition while managing many details in a distracting environment.

Compliance & Regulatory Responsibilities: NA

License/Certification: NA

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to or calling In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement

All hiring and recruitment at Healthfirst is transacted with a valid "" email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not , or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

Hiring Range*:

• Greater New York City Area (NY, NJ, CT residents): $46,200 - $62,400
• All Other Locations (within approved locations): $40,100 - $58,240

As a candidate for this position, your salary and related elements of compensation will be contingent upon your work experience, education, licenses and certifications, and any other factors Healthfirst deems pertinent to the hiring decision.

In addition to your salary, Healthfirst offers employees a full range of benefits such as, medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions (all benefits are subject to eligibility requirements). Healthfirst believes in providing a competitive compensation and benefits package wherever its employees work and live.

*The hiring range is defined as the lowest and highest salaries that Healthfirst in "good faith" would pay to a new hire, or for a job promotion, or transfer into this role.