Note: The job is a remote job and is open to candidates in USA. Brighton Health Plan Solutions is seeking an Eligibility Service Representative who is experienced in understanding eligibility and communicating through various multi-channel features. The role involves assisting in issue resolution related to eligibility, changes to coverage, and supporting the Eligibility & Benefits team.
Responsibilities
- The ESR will be responsible for receiving and resolving caregiver inquiries
- Works with the Benefits Enrollment team to review and resolve any eligibility, hours or co-premium issues including follow-up outreach to caregivers Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions
- Demonstrate strong customer service skills, attention to detail, research & analyzation and issue resolution
- Clarify customer requirements; probe for and confirm understanding of requirements or problem
- Agent will be responsible for managing caregiver requests within required turnaround time including conducting outreach to internal partners, engaging the support of the Team Leader and Supervisor as necessary
- Communicate effectively with individuals/teams to ensure high quality and timely expedition of customer requests
- Participate in activities designed to improve customer satisfaction and business performance
- Use decision-support tools to answer questions, where needed
- Ability to use critical thinking to solve complex problems and identify when to escalate to the appropriate department
- Performs call center functions including handling inbound calls and support projects as directed by the management
- Maintain broad knowledge of client requirements, procedures and key contacts
- Support projects and other departments in completing tasks when directed by management
Skills
- Bilingual in Russian/English or Korean/English
- Flexible availability for alternate schedules/hours, including shifts between 11AM and 9PM EST, Monday through Friday, with training from 9AM to 6PM
- Experience in high-volume enrollment and eligibility transactions, premium billing, and collections
- Knowledge of labor and commercial carrier enrollment procedures
- Prior high-volume call center experience
- General knowledge of HIPAA Confidentiality
- High School diploma or GED
- Remote work capability with internet access
- Basic computer skills, including Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)
- Strong investigative and time management skills
- Courteous and customer-service oriented
- Detail-oriented and dependable
- Effective communication through multiple channels (email, chat, voice)
- Preferred experience in enrollment/eligibility roles, especially in commercial and labor plans
- Previous multi-channel experience (voice, email, chat) is a plus
- Some college or business school education is advantageous
Company Overview
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