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Amida Care · 1 month ago

Member Services Representative - Bilingual

New York, NY, US

Full-time

Onsite

Entry Level

$42K/yr - $50K/yr

1+ years exp

Amida Care is the largest Medicaid HIV Special Needs Plan in NY, dedicated to providing comprehensive care and coordinated services for positive health outcomes. The Bilingual Member Services Representative will support the Member Services Department by delivering customer service and resolving inquiries from members and providers in a call center setting, while also conducting outreach and education initiatives.

Child CareHealth CarePharmaceutical

Diversity & Inclusion

Responsibilities

Answer members and providers’ inquiries concerning plan benefits, claims and complaints

Escalate complex and urgent member care needs to the appropriate Management or departments

Transfer members to Amida Care’s Partners for Services provided on behalf of Amida Care

Navigate different systems and databases to resolve members’ issues or concerns

Document all conversations/touchpoints in the Amida Care system (Salesforce)

Meet Quality Assurance requirements and other call center key performance metrics

Collect and document prospective members information the Amida Care system (Salesforce)

Conduct outbound calls for projects and member outreach follow–ups

Confirm and update member contact information and demographic, such as address, phone numbers & Primary Care Provider etc

Promote and educate members on plan benefits, services, programs, alerts, and reminders

Conduct New Member Orientation as assigned

Utilize translation line as needed to communicate with members

Attend events as needed: Town Hall Meetings, Live Your Life (LYL) Events, NML (New Member Luncheon)

Provide feedback to management teams on any trending member inquiries and/ or activities for process improvement

Perform other duties as assigned

Qualification

Customer Service ExperienceBilingual Spanish/EnglishHIPAA ComplianceMicrosoft Office ProficiencyMulti-tasking AbilityCultural SensitivityCommunication Skills

Required

High School Diploma or equivalent combination of education and relevant work experience required

Bilingual Spanish/ English

Minimum one (1) years' experience in Customer Service

Must be able to maintain strict confidentiality of sensitive member's information (HIPAA)

Proficiency in Microsoft Office (Word, Excel)

Strong verbal and written communication skills in English and Spanish

Ability to sit for an extended period

Ability to manage multiple tasks and work consistently in a fast-paced environment

Understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts in accordance with the organization's vision, mission, and values