Field Service Agent - Manhattan - Spanish

Duties/Responsibilities

• Provide high-quality customer service to providers and members across all LOBs on topics such as eligibility, benefits, claims process, escalations, and products
• Manage face-to-face encounters to provide information, improve member experience, and reduce waiting time
• Identify and de-escalate situations where member/provider is dissatisfied and provide satisfactory resolution
• Build sustainable relationships of trust through open and interactive communication
• Provide ad-hoc assistance to cross functional teams working on campaigns and case reviews
• Partner with other member-facing departments by participating in community events to engage and educate members
• Comply with HIPAA requirements and maintain PHI confidentiality; adhere to compliance and regulatory guidelines
• Assist periodically with weekend responsibilities at Community Offices or other events
• Initiate investigations, participate in root cause analysis, communicate complex information, and recommend process improvements
• Assist with Contact Center Operations outbound campaigns on high volume days
• Additional duties as assigned

Minimum Qualifications

• High School Diploma or GED equivalent from an accredited institution
• Experience in a customer service environment
• Experience handling escalated issues, complex situations, and interactions requiring conflict resolution, active listening, and empathy
• Experience working in a fast-paced environment handling multiple priorities simultaneously
• Willing to accommodate flexible business needs (nights, weekends, holidays, alternate locations, overtime with limited notice)
• Work experience with Microsoft Office Suite applications including Excel, Word, and Outlook
• Effective communication verbally and in writing with good grammar, spelling, and punctuation skills

Preferred Qualifications

• Associate degree from an accredited institution or equivalent work experience
• Ability to exercise independent thinking, problem solving and achieving goals
• English proficient bilingual who also speaks Spanish
• Basic knowledge of operational health plan departments and functionality
• Knowledge and experience with a traditional and/or omnichannel contact center in the healthcare industry, including KPIs, CMS/NYSOH requirements (including CMS STARS programs) and call center operations
• Trained in multiple Healthfirst LOBs for both Member and Provider Family of Products (FOPs)