Customer Service Specialist III

Rochester, NY 14650

Posted: 02/18/2019 Employment Type: Contract Industry: CSR Job Number: 3670612

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Duties / Responsibilities:

Provide assistance to consumers seeking health care coverage including providing information on financial assistance programs and public health care programs (Medicaid, FHP, and CHIP).

Process applications for health care coverage via the telephone including building tax household, household income, eligibility determinations, and interpreting of determinations.

Process enrollments into QHPs, plan changes, and disenrollments.

Processing of life events and special enrollment periods.

Assist Brokers and Navigators with inquiries and eligibility and enrollment issues as appropriate.

Transfer/referrals of calls to appropriate entities including in-person assisters, LDSS staff, issuers, other consumer support resources, and SHOP Service Center specialists.

Perform co-browse interactions with consumers seeking assistance with the application process via the HBE Portal.

Assist customers including prospective enrollees and people assisting enrollees or acting on their behalf, via the phone and web in accordance with all Department and Company performance standards, policy and procedures, and protocols.

Assist in explaining plan enrollment options including but not limited to covered services, participating providers, and cost.

Provides information and direction to callers regarding web-based, mail-in and telephone application/renewals, and other programs as applicable.

Facilitates the fulfillment of caller requests for materials via mail, email, or download.

Responds to all inquiries consistent with confidentiality and privacy policies and refers callers to alternate sources when appropriate.

Accesses, reads, and interprets data elements on all applicable Company and state systems to provide support, resolve inquires, and educate callers.

Escalate calls or issues to the appropriate designated staff for resolution as needed.

Enters appropriate data and information into the applicable systems to process applications and/or update caller information, confirm the accuracy of the customer information and uses every call as an opportunity to provide education and support.

Facilitates translation services for non-English speaking callers according to procedures.

Attends meetings and trainings as requested and maintains up-to-date knowledge of all programs and systems.

Performs other duties as assigned by management.


Education Required: Associates or Bachelor s degree from an accredited college or university and/or previous experience in customer service.


Background & Experience Required: Preferable experience in a Call Center, human services, health care or service-related field.

Laura Spencer
Client Relationship Manager

Laura grew up in the Boston area. She is focused and has a positive attitude which works to set each candidate up for success!

Fun Fact: Outside of recruiting, Laura is interested in sustainable living, art, and artificial intelligence.

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