Customer Service Representative I
Company: Metroplus Health Plan
Location: New York
Posted on: September 18, 2020
Customer Service Representative IJob Ref: 56532
Department: PATIENT RELATIONS
160 Water St. #3, New York, NY
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $41,985.00
Salary Range: $41,985.00 - $41,985.00
Marketing StatementMetroPlus Health Plan provides the highest
quality healthcare services to residents of Bronx, Brooklyn,
Manhattan, Queens and Staten Island through a comprehensive list of
products, including, but not limited to, New York State Medicaid
Managed Care, Medicare, Child Health Plus, Exchange, Partnership in
Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned
subsidiary of NYC Health + Hospitals, the largest public health
system in the United States, MetroPlus' network includes over
27,000 primary care providers, specialists and participating
clinics. For more than 30 years, MetroPlus has been committed to
building strong relationships with its members and providers to
enable New Yorkers to live their healthiest life.
Customer Services Representatives (CSRs) are responsible for
providing comprehensive high-quality service to all customers. The
primary responsibilities, include but are not limited to, answering
customer calls, proactively working to resolve our members and
providers questions and concerns, responding to and documenting all
customer encounters, intaking complaints, conducting outreach and
retention efforts, assisting with PCP selections and handling all
provider inquiries related to eligibility, claims and
- Strive for first call resolution, working to resolve member and
provider issues at the point of contact
- Utilize dual monitors and leverage computer-based resources to
find answers to customer questions
- Research and respond accurately to all customer inquiries
related to eligibility, benefits/ services, claims and
- Classify and record all customer encounters clearly and
- Identify and escalate complex issues and provide follow-up/
- Identify and intake customer complaints capturing all pertinent
- Assist members with PCP selection, as well as, locating
providers and vendors within Plan's network.
- Verify and update member demographic information.
- Process requests for member materials, such as ID cards, member
guide, provider directory, etc.
- Handle enrollment inquiries and generate sales leads.
- Handle disenrollment requests and pro-actively conduct
- Perform outreach related to New Member Orientation and PCP
Term/ Resign projects.
- Process premium payments.
- All other duties and special projects as assign by the Director
of Customer Services.
- Ability to work between 8:00AM and 8:00PM Monday - Friday, and
- Training class (Paid): 9:00AM-5:00PM Monday-Friday
- High School graduation or evidence of having satisfactory
passed a High School Equivalency Program; and
- Minimum 1 year experience in a call center environment or a
satisfactory equivalent combination of education, training and
- Proven experience in providing excellent service to customers
in various healthcare related areas, (i.e. insurance, doctor's
office, medical clinics)
- Poise under pressure when dealing with difficult situations and
potentially upset customers
- Ability to work in a fast-paced environment while keeping a
high attention to detail
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication
Keywords: Metroplus Health Plan, New York , Customer Service Representative I, Sales , New York, New York
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