*** NOW HIRING ***Company Overview: TRICARE Prime military health plan sponsored by the Department of Defense (DoD). We provide the full TRICARE Prime benefit including routine doctor visits, specialty care, hospitalization, urgent and emergent care, preventative health care services and prescription coverage. Schedule/Shift: 9am - 5pm Location: Midtown Manhattan - MUST BE local to NYC HYBRID - Monday/Friday remote & Tuesday - Thursday in office Pay: up to $23/hr Overview
- Responds to incoming member and provider inquiries via phone, email, or in person, in alignment with call center performance standards and regulatory requirements.
- Accurately documents and tracks all inquiries in the call tracking system in a timely manner.
- Resolves inquiries related to plan benefits, eligibility, referrals, authorizations, pharmacy, and claims with professionalism and empathy.
- Educates members and providers on health plan benefits, navigation, and available resources to promote self-service when appropriate.
- Ensures a high level of customer satisfaction by resolving issues efficiently and identifying opportunities for service improvement.
- Updates and verifies member/provider information, processing demographic and PCP changes as needed.
- Follows triage and escalation protocols, taking ownership of issues through to resolution.
3-5 Must Have Skills/Qualifications
- High Volume health plan call center experience (over 50 calls a day)
- Ability to be efficient on the calls (ideal time on call is 3-5 minutes)
- Punctual/Strong attendance
- High school or equivalent diploma (Must have physical copy of diploma or GED, cannot accept transcripts)
We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients. We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA). This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.