Company name
Humana Inc.
Location
Albany, NY, United States
Employment Type
Full-Time
Industry
Customer Service, Call Center
Posted on
Apr 12, 2023
Profile
Job Information
Humana
Consumer Service Operations Representative
in
Albany
New York
Description
The Consumer Service Representative 3 will focus on membership retention of current and new members by providing local proactive 'high touch' outreach and enhanced member experience. This role includes functions relative to benefits, enrollment and eligibility, member support, claims interpretation and processing, agent support, onboarding, local agency outreach, billing issues, payments, provider questions and call center operations. The Representative will regularly exercise discretion and judgment in prioritizing requests, interpreting, and adapting procedures, processes, and techniques.
Responsibilities
This is a hybrid position - working approximately 3 days a week from home and 2 days out of a mobile Humana RV office in the Brooklyn/Bronx/Queens areas.
The Consumer Service Representative 3 will work alongside a sales Manager in a specific market by making outbound calls and proactively managing potential member dissatisfaction. The associate will focus on membership retention of current and new members by providing local proactive customer service as it relates to members plan i.e., benefits, enrollment, eligibility, billing issues, payments, provider questions. Associate will be responsible for making outbound calls as well as having the flexibility to work alongside with local sales agents and leaders.
Key Accountabilities -
Contact provider office
Contact Pharmacy
Handling of escalated issues
Communication with members, agents and managers
Interaction with peers, sale agents and leadership- Collaboration and resolution
Representatives must document and track all interactions based upon CMS guidelines, participate in interdepartmental discussions and planning and assist the Enterprise Test and Learn Committee in measuring retention impact.
Required Qualifications
1 - 2 years of customer service experience, preferably in a role focused on customer retention and resolving/preventing customer issues.
Bilingual - English and Spanish
Must live in the NYC Metro area and have ability to work from home and out of a mobile RV office
Previous inbound and/or outbound call center or related customer service experience
Aptitude for quickly learning and navigating new technology, systems, and applications
Proficient in Microsoft Office Outlook and Word
Working knowledge of computers, or a demonstrated technical aptitude and an ability to quickly learn new systems
Preferred Qualifications
Healthcare experience and/or sales or business development
Clerical support background in a healthcare environment
Familiarity with medical terminology
Medicare experience strongly preferred
Work at Home Requirements
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Associates who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office associates with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information
#LI-JB2
Scheduled Weekly Hours
40
New York City Pay Range
The compensation range represents a good-faith estimate of starting pay at the time of posting and may vary based on geographic location and/or employment type. Individual pay decisions will vary based on demonstrated job-related skills such as education, experience, certifications, etc.
$44,600 - $61,250
Pay Type
Hourly
Incentive
This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, 'Humana') offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=Humana_Website.
Company info
Humana Inc.
Website : http://www.humana.com