Customer Service Representatives (NEW YORK)

Customer Service Representative

EmblemHealth is a health and wellness company that provides insurance plans, primary and specialty care, and wellness solutions. As one of the nation's largest not-for-profit health insurers, we serve more than three million people in the New York tristate area.

All positions will be onsite at our corporate office located at 55 Water Street, New York, NY 10041.

Work Shifts:

• Monday through Friday, shifts between 8 a.m. to 8 p.m. (35-hour work week)

Training:

• Must be available to attend 8-week paid training program, Monday through Friday, 10 a.m. – 6 p.m.

Compensation and Benefits:

• Hourly Pay Rate is $24.67
• We offer competitive health and wellness benefits

Position Description:

• Receive, answer and/or record telephone/correspondence/e-mail inquiries from subscribers, providers, and other consumers relating to areas of coverage, payment of claims, membership status, medical management intake calls, etc., under the various EmblemHealth medical/surgical, dental, hospital and Medicare plans.
• Review inquiries, correspondence and email receipts. Prepare email resolutions, letters (form or narrative letter) and/or claims payment process adjustments.
• Perform written and verbal duties of the position to meet company goals for production and accuracy.
• Perform related claims approving and clerical work as assigned.
• Perform other duties as assigned or required.
• Regular attendance is an essential function of the job.

Qualifications:

• Must be able to work under pressure, handle stressful situations effectively and deal politely with subscribers and providers on the telephone, in person, and email/correspondence
• Ability to detect and relate problem service issues to management
• Ability to speak well on the telephone and maintain a positive telephone personality
• Must be able to compose clear concise letters
• If designated, sort and screen correspondence receipts and resolve via coding of additional payment, possibly including salvage and/or completion by letter
• Typing and PC skills
• Ability to adapt to change and address multiple issues simultaneously
• Good organizational skills
• Must be available for training

Education and Experience:

• A minimum of two (2) years' experience in customer service; one year must be in a call center setting
• A college degree is preferred
• Health insurance experience is a plus