Customer Service Representative. Member Services Call Center Position Available In Fulton, New York

Job Description:

Date Posted:

06/13/2025

Hiring Organization:

Rose InternationalPosition Number:

484174

Industry:

Healthcare Job Title:

CustomerService Representative.

Member Services Call Center Job Location:

Fulton, MD, USA, 20759

Work Model:

Hybrid Work Model Details:

Remote (Local to Fulton, MD)

Shift:

Weekend work is required, withshifts ending as late as 9:30

PM EST Employment Type:

TemporaryFT/PT:

Full-Time Estimated Duration (In months): 7 Min Hourly Rate($): 20.57 Max Hourly Rate ($): 20.57

Must Have Skills/Attributes:

Call Center, Customer Service Experience Desired:

Bilingual inSpanish required (2 yrs); Call center or customer serviceexperience required (Healthcare preferred) (2 yrs)

Required MinimumEducation:

High School Diploma or equivalent

Job Description WorkModel:

• Fully Remote (Must reside near Fulton, MD)
• Bilingual inSpanish required

Required Education:

• High School Diploma orGeneral Education Development (GED)

Required Qualifications:

• Minimum two (2) years of call center or customer service experiencerequired (Healthcare preferred)
• Excellent written and verbalcommunication skills.

Demonstrated analytical and problem-solvingskills. Working knowledge of systems used within the MSCC.

Additional Job Requirements:

• Workers are expected to be inattendance daily during/after training
• Training will be 3 months.

No time off will be approved

• No time off during training and/orfirst 90 days of assignment
• No time off during training, nestingand/or first 90 days of assignment. This includes doctor’sappointments. Three attendance violations during training/nestingcan and will result in early termination.
• Must be flexible towork weekends and a late shift
• Internet must be hardwired (noWi-Fi accepted)
• Must have strong internet speed and a quiet placefor remote work Shifts during training and nesting as well asproduction operation hours: Fulton
• 08/11 (Supporting MAS Region)

• Training:

  8:00 AM

• 4:30 PM EST

Nesting:

8:30 AM

• 5:00

PM ESTProduction Operation Hours:

• Will be required to work nights andweekends as late as 9:30 PM for all locations.

Shifts aredetermined by business need once training is completed.

InternetRequirements:

• Internet must be hardwired (no Wi-Fi accepted)
• Must have strong internet speed and a quiet place for remote work

Summary :

The Customer Service Representative is responsible forincreasing customer satisfaction and retention by providingmembers, customers, patients, and providers with accurate,consistent, timely, and meaningful information. They will providesupport to members” inquiries and issues as they utilize theClient plan and provider services, continuing to build rapport andcollaborative relationships with current and prospective members inaccordance with compliance guidelines. Major Responsibilities /

Essential Functions:

• Available to handle member inquiriesregarding:

Member Core:

Facility Inquiry, Web Support, PromoteClient, Order ID Card, Complaint, ID Card Inquiry, Service Review.

Member Advance:

Eligibility Inquiry, Benefit Inquiry, General,Complaint, Correspondence Inquiry, Add/Remove Dependent, ServiceReview, New Member Experience, Internal Regional Request, IVRDefaults.

• Medicare (For up to two (2) regions).

Premium BillingEnterprise:

Billing Inquiry, Make Payment, Complaint, EFT Inquiry,General, Reinstatement Request, Service Review.

• Client Billing,1095 Tax Form, SLP (escalations to Tier 3).
• Represents HealthPlan by answering and documenting all incoming contacts todetermine their nature and to respond to complex calls related tospecialized product lines or queues.
• Responds professionally toinquiries from internal/external customers.
• Promotes, ensures,and provides customer service to internal/external customers bydemonstrating skills consistent with the organization’s philosophyof providing extraordinary customer relations and quality service.
• Initiates contact with the appropriate Health Plan, medicalgroup, and facility personnel to obtain information relevant to theconcern or inquiry as needed.
• Evaluates data to determine andimplement the appropriate course of action to resolve the complaintand/or coordinate service recovery.
• Documents conversations withmembers according to procedure.
• Follows established procedures tomeet customer/member needs.
• Required to effectively interact withdiverse work units and relevant organizational departments.
• Hassubstantial understanding of the assigned skills and appliesknowledge and skills to complete a wide range of tasks.
• Abilityto understand relevant policies, processes, and customers.
• Assists the department in meeting customer needs and reachingdepartment expectations.
• Completes required training andunderstands how to use tools available to recall necessaryinformation.
• Develops a full awareness of the way performance andactions affect members and Member Service Contact Center’s (MSCC)performance guarantees (call handling, first call resolution,complaint resolution compliance, member retention, and returncontact as warranted).
• Consistently supports compliance and thePrinciples of Responsibility (Client Code of Conduct) bymaintaining the privacy and confidentiality of information andprotecting the assets of the organization.
• Performs otherrelevant duties as required.

Only those lawfully authorized to workin the designated country associated with the position will beconsidered. Please note that all Position start dates and durationare estimates and may be reduced or lengthened based upon aclient’s business needs and requirements.

Benefits:

For informationand details on employment benefits offered with this position,please visit here. Should you have any questions/concerns, pleasecontact our HR Department via our secure website.

California PayEquity:

For information and details on pay equity laws inCalifornia, please visit the State of California Department ofIndustrial Relations’ website here.