Bilingual Consumer Support Specialist at New York

Job Description

Division#:

Division Name:

Job Categories: Customer Service, Government, Health Care

Job Responsibilities: Job Responsibilities

Job Responsibilities:

Maintains updated knowledge of Insurance Affordability Programs and the information required for eligibility, including income rules based on Modified Adjusted Gross Income (MAGI) and other rules that will be used to determine eligibility for Medicaid, CHIP, APTC, and the SHOP Exchange.

Maintains updated knowledge of the characteristics and eligibility rules governing the non-MAGI population to ensure non-MAGI applicants are referred tot he appropriate entity

Maintains updated knowledge of project and corporate policies and procedures as referenced in the employee manual and other desk procedures for the position.

Accesses, reads, and interprets data elements on all applicable MAXIMUS, NY HBE, and systems to provide support, resolve inquires, and educate callers.

Provide assistance to consumers seeking health care coverage including providing information on financial assistance programs and public health care programs

Process applications for health care coverage via the telephone including building tax household, household income, eligibility determinations, and interpreting of determinations made by the NY HBE system

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 Small Business Health Options Program (SHOP) Service Center specialists

Perform co-browse interactions with consumers seeking assistance with the application process via the NY 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 of Health (DOH) and MAXIMUS 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.

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.

Documents all consumer inquiries using the applicable MAXIMUS, NY HBE, and State systems

Facilitates translation services for non-English speaking callers according to procedures.
Position Overview:
The Consumer Services Specialist (CSS) is responsible for servicing the individual consumers of the New York State Health Benefits Exchange (NY HBE) including but not limited to assisting individuals and families in applying for health care coverage through the NY HBE. Other responsibilities of the CSS III include responding to inquiries about Advance Premium Tax Credits (APTC), including inquiries regarding eligibility, premium payments, partial payments, grace periods, and cost-sharing reductions (CSR). CSS IIIs will also assist consumers with enrollments into Qualified Health Plans (QHPs), status checks, processing of life event changes, and referrals.

The Ideal Candidate will Possess the Following Additional Education, Experience, and Abilities:

Bilingual in English and Mandarin or Cantonese is required.
MAXIMUS (NYSE:MMS) is a leading health and human services administrator for governments in the United States, United Kingdom, Canada and Australia. We deliver administrative solutions to improve the cost effectiveness, efficiency and quality of government-sponsored benefit programs across the globe. Operating under our founding mission of Helping Government Serve the People, we have more than 7,000 employees located in more than 220 offices worldwide. MAXIMUS is an Affirmative Action and Equal Opportunity employer.

Education Required: High School Diploma or GED
Education Preferred: Associates and/or Bachelors degree from an accredited college or university

Technical Skills / Knowledge Preferred: Proficiency in Microsoft Office (Word and Excel) and bilingual capabilities

Subject Matter Expertise/Experience Required: 0 - 2 years of related experience
Subject Matter Expertise/Experience Preferred: Experience working with culturally/linguistically diverse and disadvantaged populations in a courteous and effective manner

Personal/Soft Skills: Customer service, organizational, interpersonal written and verbal communications skills, ability to interact courteously and effectively with a variety of people, ability to perform comfortably in a fast-paced, deadline-oriented work environment, ability to work as a team member, attentional to detail, as well as independently and ability to work under standards-based performance measures

Duties / Responsibilities:
1. Provide info to customers in a courteous, polite and professional manner
2. Perform accurately all data entry
3. Assist customers in problem resolution
4. Receive and respond to telephone calls
5. Answer questions of a general nature and direct incoming calls
6. Initiate follow-up calls to customers
7. Maintain confidentiality and security of information
8. Must be able to take direction from appointed Mentor/SME for training purposes or when immediate supervisor is not available
9. Operate multi-line phone system, answer incoming telephone calls and perform other clerical duties proficiently and professionally
10. Respond to needs, questions and concerns of internal and external customers
11. Comply with current and updated policy and procedures
12. Perform other duties as may be assigned by management

MAXIMUS offers a comprehensive benefits package including:

Healthcare Insurance (medical, dental, vision)

Short and Long Term Disability Insurance

Life/Accident Insurance

Flexible Spending Accounts (FSA)

401(k) Retirement Plan with company match
Our benefit program also includes paid holidays, PTO, tuition reimbursement, and supplemental insurance (auto and pet insurance discounts, legal plan, and credit union).

Job Requirements

 
Country: USA, State: New York, City: New York, Company: Maximus.