Job Details
For the last 80 years, EmblemHealth has been taking care of New Yorks heart and soul, its people. Today, health care is more complex than ever. Thats why were at the forefront of change. We work alongside our customers to offer access to high-quality, affordable care, help navigate the health care experience, and make good health achievable; because everyone deserves to be taken care of. We deliver on our mission every day by living our values with our colleagues, members, clients and partners. It begins with **caring** and respecting all those we work with. We believe a culture of **diversity** and inclusion is vital to serve our unique and diverse customers. We seek for continues improvement and innovation and believe being agile and nimble is our advantage. We bring a strong sense of **partnership** to every relationship internally and externally. The EmblemHealth family of companies offers competitive health, welfare, and retirement benefits as well as incentive pay plans and more. ** Customer Service Representatives (Multiple Positions)**
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New We are seeking dynamic Customer Service Representatives to join our Call Center in Albany, NY starting February 2022! The Customer Service Representative will provide customer service support to EmblemHealth members. Inquiries can range from verifying information, question regarding bill, locating a Physician in accordance to their plan, etc. They will be responsible for addressing any issues under EmblemHealths various plans as it relates to areas of coverage, payment of claims, membership status, medical management intake calls, etc.
**Description of Duties:**
* 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.
**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.
* Regular attendance is an essential function of the job
**Education and Experience:**
* A minimum of two (2) years experience in customer service; 1 year must be in a call center setting.
* A college degree is preferred.
* Health insurance experience is a plus
**Test Subjects:**
* O nline: Reading Comprehension
* Online: Customer Service
* Oral Telephone Simulation; Interview
Additional Information
* Requisition ID: 211JU
**Sponsorship Statement**
Depending on factors such as business unit requirements, the nature of the position, cost and applicable laws and regulations, EmblemHealth may provide work visa sponsorship for certain positions.