Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
If you’re an EmblemHealth employee, unlock your career potential by signing in at the top of this page. Access your employee profile to view internal job postings and explore new opportunities.
Senior Customer Service Associate
Summary:
- Research, mentor and provide issue resolution, including escalated calls with a member-centric sense of urgency.
- Identify, recommend, and implement process improvement opportunities to elevate the member experience and create call center efficiencies; support a variety of production non-phone tasks, correspondence and complex research while working closely with the training team to present training opportunities based on data and trending.
- Actively participate as a Subject Matter Expert (SME) on cross-functional projects from initial development to implementation; create and promote a culture that inspires others towards teamwork and collaboration as well as customer advocacy.
Responsibilities:
- Resolve provider and member issues: provide constant feedback and recommend solutions/resolutions.
- Serve as customer advocate by providing assistance to resolve callers’ issues and problems; ensure proper issue closure and documentation.
- Serve as primary resource to respond and handle in-person customer support.
- Non-call tasks: Analyze and work production baskets to ensure timely resolution.
- Provide high quality, timely and accurate responses to customer correspondence and report requests.
- Leadership and support: mentor and coach Customer Service Associates.
- Serve as backup for/extension of leadership team empowered to handle emotional, escalated calls.
- Process improvement: identify, research and exploit cross-functional process improvement opportunities.
- Track and trend issues to determine if education or policy and procedural updates need to be made.
- Serve as primary source of expertise for projects and initiatives.
- Provide technical, administrative, and experiential support as needed on tasks/projects.
- Accountable for being an ambassador of the call center vision and mission, and inspire others towards teamwork, customer advocacy, and positive culture.
- Perform other related projects and duties as directed or required.
Qualifications:
- Bachelor’s Degree - additional experience/specialized training may be considered in lieu of educational requirements required
- 2 – 3+ years of relevant, professional work experience required
- Knowledge of medical terminology/coding; provider reimbursement; coordination of benefits; and medical claims required
- Ability to successfully manage multiple tasks simultaneously, with varying priority levels and deadlines required
- Ability to handle high volume of calls efficiently and courteously required
- Excellent customer service skills (telephonic, electronic, and in-person) required
- Excellent communication skills (verbal, written, interpersonal) with all types/levels of audience required
- Attention to detail; problem identification and resolution skills required
- Ability to perform basic to moderate analysis of information and data preferred
- Ability to perform in office environment with extended periods of sitting, using telephone, and viewing computer screens, standing, and reaching, lifting, filing required
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, age, creed, citizenship status, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
At EmblemHealth, we are committed to building a diverse and talented workforce. However, we are unable to consider applicants who require, or are likely to require, either before or after hire, visa sponsorship for work authorization in the United States, including but not limited to H-1B, F-1 (STEM OPT), TN, or any other non-immigrant status. Some extremely rare exceptions may apply based on critical business needs.