Customer Service Representative

First point of contact for all customer service issues. Responsible for ensuring patient/client medications, supplies and equipment are accurately recorded and sent to distribution. Consults with Supervisors to ensure timely and accurate delivery of supplies/equipment. Maintains patient privacy and confidentiality at all times according to established procedures. Provides positive, supportive communication to supervisor, patients, families, visitors and company personnel

Recertification/renewal of membership

Assist all line of business (Medicaid/Medicare/MLTC/CHP/EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours as well as weekends. This is designed to optimize telephone outreach with members who are due to recertify.

Follow appropriate processes to meet and exceed recertification targets set by the department

Make the recertification process as easy and seamless as possible for our members

Assist members with completion of recertification applications

Partner with different parts of the organization to understand any barriers to the member s experience and work to resolve them appropriately

Meet daily outreach and renewal goals that contribute to overall member retention for the organization

Enrollment and retention support

Assist members with completion of all enrollment activities including but not limited to changing lines of business to ensure member is in the optimal plan, re-enrolling members due to administrative issues, premium payment, etc.

Assist members with PCP selection as well as locating providers and vendors within the Plan s network

Provide end-to-end customer support to drive customer satisfaction and improve customer experience

Interface with internal and external stakeholders to ensure complete resolution

Communicate verbally and in writing with members for all necessary member retention activities

Process improvement

Devise solutions in response to member dissatisfaction/complaints/issues in support of ongoing organizational improvement efforts

Support any ad hoc projects on process improvements

Report common trends identified during member outreach

Job Title: Customer Success Specialist I Work Schedule: Full time Hours Per Week: 35 Days: Monday, Tuesday, Wednesday, Thursday, Friday Shift time: 9am - 5pm Work location: Hybrid Patient Facing: No Minimum education level: High school Language competencies: bilingual preferred- English & Spanish, but also interested in English & Chinese, Russian, Bengali License/Registration required