Customer Services Representative I

MetroPlus 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.

Purpose of Position:

The Customer Services Representative provides comprehensive customer service to members, providers and prospective members. The primary responsibilities include but are not limited to documenting all customer contacts into the tracking system, process complaints, conduct outreach efforts, assist in PCP selection, conduct new member orientations, claims review inquiries, handle provider and utilization management inquiries, etc.

• 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 experience.
• Proven experience in providing excellent service to customers in various healthcare related areas, (i.e. insurance, doctor’s office, medical clinics)
• Must be computer proficient and possess demonstrated written and oral communication skills.
• Fluent in a second language is preferred.