Bilingual Customer Service Rep

3+ months agoNew York, NY

The Relationship Coordinator, Outbound - bilingual Spanish 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 HF goals relate to sales performance and meet established quotas. Clearly articulate each product line to prospective clients.

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).

Duties & Responsibilities:

• Calls prospective SHP clients according to approved scripts within 24 hours.
• Searches ePACEs for Medicaid eligibility, exclusion and exemption codes.
• Documents all client calls /outcomes in pre-enrollment database system.
• Achieves daily, weekly and monthly goals for outbound telemarketing calls and booking appointments.
• Calls prospective HF CompleteCare clients according to CMS approved scripts within 24 hours.
• Searches ePACES for Medicaid/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 HF CompleteCare Specialist and Intake Nurses in EMR within 48 hours referral receipt while maximizing joint visits (Specialist + Nurse).
• Documents all special instructions in EMR schedule notes.
• Documents all client replies to calls in EMR 1st-5th Contact milestones.
• Coordinates the preparation of fulfillment kits to prospective members or those requesting addition information in a timely manner.
• 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

Please note: Since we care so greatly about our employees' and members' wellbeing, Healthfirst is moving to a fully vaccinated in-office environment. You must be vaccinated to work in our offices, even if you are partially remote. If you are selected to interview for this role, we will explain our vaccination policy and ensure you are comfortable moving forward with further interviews based on your work location.

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 212-519-1798 . 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.

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