Essential Duties and Responsibilities:
- Serve as a subject matter resource for customer inquiries received via telephone, interactive voice response (IVR), web based portals, or outreach activities regarding program information and services.
- Manage and support escalated enrollment cases and processes in accordance with established case resolution procedures.
- Respond to complex or sensitive customer concerns by applying program policies, procedures, and guidelines to determine appropriate actions or referrals.
- Accurately document customer interactions, case activity, outreach efforts, and actions taken in applicable systems.
- Navigate and utilize multiple systems, tools, and data sources to retrieve, review, compare, analyze, and verify customer or program information.
- Conduct outbound contacts to customers to obtain corrections, clarification, or required documentation to support case resolution or enrollment verification.
- Review and compare customer submitted documentation, including income or eligibility materials, against application data to verify accuracy and compliance.
- Apply program knowledge to educate customers on program offerings, eligibility requirements, enrollment options, and available services.
- Support customers throughout multiple phases of the application or service lifecycle, from enrollment through receipt of benefits or services.
- Identify issues, trends, or barriers impacting customer engagement or service delivery and report concerns to management or project staff as appropriate.
- Collaborate with internal teams, client escalation groups, and external partners to support effective resolution of customer issues and project objectives.
- Maintain confidentiality and security of customer, provider, and program information at all times.
- Meet or exceed established productivity, quality assurance, and performance standards.
- Attend required meetings and trainings and maintain up to date knowledge of programs, systems, policies, procedures, and compliance requirements.
- Perform other related duties as assigned by management.
- Conduct face-to-face and/or virtual (telephonic) outreach and enrollment services, including education on managed care options and public health programs to clients at LDSS/HRA offices
- Assist clients with the enrollment/transfer/disenrollment process
- Interface and maintain professional and positive relationships with HRA/LDSS county staff and clients
- Assist Call Center Operations and other departments as determined by project management to meet business needs
- Regular member of a processing unit within the Outreach department:
EEU
Data Entry
Manual Notices
- Conduct shadowing / training activities with new hires
- Works in assigned special projects
- Maintain Certified Application Counselor (CAC) active certification
- Conduct Certified Application Counselor (CAC) tasks in select counties
- Maintain updated knowledge of the New York Medicaid Choice Project
- Meet all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position
- Perform other duties as assigned by Management
Minimum Requirements
- High school diploma or GED required and 6+ months of relevant professional experience required, or equivalent combination of education and experience.
- Prior work experience in customer service, data entry and/or data processing
- Experience working with MS office applications (Excel, PowerPoint & Word)
- Must be able and willing to travel and provide site coverage as needed
Preferred Requirements
- Some college or college degree
- Experience with New York Medicaid
- 2+ years of experience in customer service or related position
- Follows established guidelines and directions while maintaining a proactive approach to meeting objectives and deadlines.
- Effectively manages multiple tasks and priorities under pressure, ensuring high-quality outcomes in a fast-paced environment.
Home Office Requirements for 1 to 2 weeks of remote training
- Candidates must have their own laptop/computer equipment with Windows 11 Operating System or MacOS 13 Ventura or higher.
- Private and secure workspace
- Reliable high-speed internet service
- Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity
- Minimum 5 Mpbs upload speeds
Maximus Required Computer Operating System for 1 to 2 weeks of remote training
- Windows11 or MacOS Catalina (10.15), MacOS Big Sur (11), MacOS (up to 12.5) or newer.
- For HP Users, Maximus requires removal of SMode
Maximus restricts smartphone and low performing computer platforms (such as chromebooks) from accessing Amazon WorkSpaces (AWS).
#NYMC #NYMCCSR #LI-Onsite
EEO Statement
Maximus is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, age, national origin, disability, veteran status, genetic information and other legally protected characteristics.
Pay Transparency
Maximus compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected quality and quantity of work, required travel (if any), external market and internal value analysis including seniority and merit systems, as well as internal pay alignment. Annual salary is just one component of Maximus's total compensation package. Other rewards may include short- and long-term incentives as well as program-specific awards. Additionally, Maximus provides a variety of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, paid holidays and paid time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. Maximus will comply with regulatory minimum wage rates and exempt salary thresholds in all instances.
Accommodations
Maximus provides reasonable accommodations to individuals requiring assistance during any phase of the employment process due to a disability, medical condition, or physical or mental impairment. If you require assistance at any stage of the employment process-including accessing job postings, completing assessments, or participating in interviews,-please contact People Operations at [email protected] .
Minimum Salary
$18.00
Maximum Salary
$20.50
