Customer Service Representative

Customer Service Representative at Pride Health Customer Service Representative at Pride Health in Weehawken, New Jersey Posted in 5 days ago.

Type:

full-time

Job Description:

Position Overview The Customer Success Specialist I supports Client members and key stakeholders throughout the customer journey. This role serves as a subject matter expert on Client processes and acts as a liaison to ensure members receive timely resolutions and support. The ideal candidate is customer-focused, detail-oriented, and passionate about delivering an exceptional member experience that drives retention and satisfaction through both inbound and outbound outreach. The Customer Success Specialist I will oversee member retention activities and serve as a single point of contact for issues escalated to the Customer Success department. Key Responsibilities Membership Recertification & Renewal Support retention efforts across all lines of business including Medicaid, Medicare, MLTC, CHP, and EP Conduct outbound member outreach using strategic schedules, including morning/evening hours and weekends when needed Guide members through recertification and renewal processes Assist with completion of recertification applications Meet daily outreach and renewal goals Collaborate with internal departments to resolve barriers impacting the member experience Enrollment & Retention Support Assist members with enrollment activities and plan transitions Support re-enrollment due to administrative issues Help members with premium payments, PCP selection, and locating providers/vendors within the network Deliver end-to-end customer support to improve member satisfaction Communicate effectively with members verbally and in writing Coordinate with internal and external stakeholders to ensure complete issue resolution Process Improvement Identify and report trends from member interactions Recommend solutions for member complaints and dissatisfaction Participate in process improvement initiatives and special projects Perform additional duties as assigned Qualifications High school diploma or equivalent required Strong customer service and communication skills Ability to manage multiple tasks and priorities in a fast-paced environment Experience working with diverse populations preferred Bilingual language skills highly preferred

Benefits:

Pride Health offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.