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Healthfirst

Non-profit insurer offering MLTC, Medicare Advantage.

Field Service Agent - Spanish

Customer SupportPosted on Nov 10
Full-timeNew York, NY, USA

About the Job

Requirements

  • A high school diploma or GED equivalent from an accredited institution is required.
  • Experience in a customer service environment is required.
  • Experience handling escalated issues, complex situations, and interactions requiring conflict resolution, active listening, and empathy is required.
  • Experience working in a fast-paced environment while handling multiple priorities simultaneously is required.
  • Willingness to accommodate flexible business needs, including nights, weekends, holidays, alternate locations, and/or overtime with limited notice, is required.
  • Work experience with Microsoft Office Suite applications, including Excel, Word, and Outlook, is required.
  • Work experience requiring effective verbal and written communication, with good grammar, spelling, and punctuation, is required.

Responsibilities

  • Provide customer service to providers and members across all lines of business on eligibility, benefits, claims processes, escalations, products, and other questions and issues.
  • Manage face-to-face customer encounters by providing information about products and services, improving the member experience, reducing waiting time, and expediting traffic flow.
  • Identify and de-escalate situations involving dissatisfied members or providers and provide satisfactory resolutions.
  • Build relationships of trust through open and interactive communication with internal and external customers.
  • Provide ad-hoc assistance to cross-functional teams working on campaigns and case reviews to ensure standards are met.
  • Participate in community events with other member-facing departments to engage and educate existing and prospective members.
  • Comply with HIPAA requirements, maintain the confidentiality of protected health information and other member, provider, medical, and departmental information, and follow applicable local, state, federal, and company compliance and regulatory guidelines.
  • Periodically assist with weekend responsibilities at Healthfirst Community Offices or other events.
  • Initiate investigations, participate with assigned parties in root cause analysis, communicate complex information, take proactive or corrective measures or recommend solutions and process-improvement methods, and follow up on outstanding customer inquiries and complaints within defined timeframes.
  • Assist with Contact Center Operations outbound campaigns on high-volume days while meeting individual and team deliverables.

Desired Qualifications

  • An associate degree from an accredited institution or equivalent work experience is preferred.
  • Ability to exercise independent thinking, solve problems, and achieve goals is preferred.
  • English proficiency and fluency in Spanish are preferred.
  • Basic knowledge of operational health plan departments and functionality is preferred.
  • Knowledge and experience with traditional and/or omnichannel contact centers, especially in healthcare, including KPIs, CMS/NYSOH requirements such as CMS STARS programs, and general call center operations, is preferred.
  • Training in multiple Healthfirst lines of business for both member and provider families of products is preferred.

About the Company

Healthfirst

Non-profit insurer offering MLTC, Medicare Advantage.

Healthfirst is a nonprofit health insurer in the New York metropolitan area offering a range of health plans, including Managed Long-Term Care (MLTC) for people who need ongoing care, Medicare Advantage with extra benefits, and the Essential Plan for income-qualified individuals. MLTC coordinates in-home and community-based care; Medicare Advantage combines Medicare with additional benefits in a single plan; the Essential Plan provides affordable coverage through a low-cost option, all delivered through a network of healthcare providers funded by premiums and government support. It differentiates itself through its nonprofit status, strong local focus, and partnerships that connect New Yorkers to a coordinated set of public-program-aligned products alongside Medicare Advantage. Its goal is to expand access to affordable, comprehensive health coverage for New Yorkers, especially vulnerable groups, by leveraging its local presence and provider network.

Company size
1,001-5,000
Company stage
Not listed
Total funding
Not listed
Headquarters
New York City, New York
Founded
1993

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