CLIENT SERVICE REPRESENTATIVE
The Client Service Representative is responsible for interacting with customers to provide information in response to inquiries about programs and services in a contact center.
- Respond to customer inquiries received by telephone, Interactive Voice Response (IVR), or web based portal regarding information on programs and services
- Record customer interactions and transactions, by documenting details of inquiries, complaints, comments, and actions taken
- Follow standard operating procedures to ensure consistency and accuracy
- Address customers inquiries and resolve problems to ensure that appropriate changes are made
- Refer unresolved customer grievances to designated departments for further investigation
- Communicate with supervisor regarding any potential needs or concerns
- Perform data entry accurately
- Perform other duties as assigned by management
- High school diploma or GED required
- Associate degree is preferred
- 2 years of related work experience required
- Excellent organizational, written and verbal communication skills
- Ability to perform comfortably in a fast-paced, deadline-oriented work environment
- Ability to work as a team member, as well as independently
- Ability to maintain confidentiality and security of all information
- Ability to comply with current and updated policies and procedures
- Ability to interact courteously and effectively with a diverse population
- Proficient in the use of Microsoft Office products
|Title||Supervisor – Case Management|
|Advertising Title||Supervisor – Case Management|
|Division||Eastern Region, Health Services / 20-0014|
|Department||State of New York, New York Medicaid Choice Program|
|Reports To||Manager – Call Center|
|Required Education||College degree or equivalent|
|Preferred Education||College degree in social work|
|Required Experience||NYMC project experience and related programs|
|Preferred Experience||1-3 years of Supervisory experience in a health or social service field and/or 2 years of human services experience working with the public|
|Required Skills||Ability to type at least 35WPM; computer literacy; knowledge of the community to be served; ability to follow directions; excellent organizational, interpersonal, written, and verbal communication skills; ability to perform comfortably in a fast-paced, deadline-oriented work environment; ability to successfully execute many complex tasks simultaneously; ability to work as a team member; ability to work independently|
|Bilingual||Fluency may be required in commonly spoken languages for some positions|
- Supervises Case Management staff, including the functions associated with Case Management and forms processing.
- Monitors the performance of assigned staff, providing feedback and education to staff to improve performance.
- Assists Case Management counselors and lead counselors in responding to exemption and exclusion, MLTC, LTCE and FIDA calls when needed.
- Ensures Case Management staff effectively assess consumers’ health care needs and assists consumers in the exemption and exclusion, MLTC, LTCE, and FIDA processes.
- Ensures Case Management staff effectively educates consumers in managed care, accessing services, and other information.
- Ensures that the Exemption and Exclusion, Expedited Disenrollment/Transfer, Good Cause, MLTC Enrollment Denials, MLTC Involuntary Disenrollment, LTCE, and FIDA forms are being processed efficiently and accurately.
- Identifies breakdowns in the forms processing system and recommends solutions to the Central Operations Manager.
- Provides on-going training and support to Case Management counselors.
- Ensures the Case Management staff maintains updated knowledge of the project policies and knowledge of health plans that are available to consumers.
- Ensures Case Management staff effectively assists consumers in enrolling / disenrolling in health plans.
- Checks exemption, expedited disenrollment, good cause, MLTC Enrollment Denials, MLTC Involuntary Disenrollment, and FIDA report logs.
- Communicates with consumers.
- Communicates with Local Department of Social Service Offices on E&E, MLTC, LTCE, and FIDA issues.
- Ensures E&E, MLTC, LTCE and FIDA documentation are up to date.
- Some Saturday work required.
- Meets all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position.
- Performs other duties as may be assigned by the Central Operations Manager.