Project Specific Job Description & Requirements:
The Consumer Services Specialist (CSS) III is responsible for answering inquiries from Marketplace individual consumers including but not limited to general information as well as assisting individuals and families in applying for health care coverage through the Marketplace.
Education & Experience Required:
-Answer incoming calls from consumers including the general public, prospective enrollees and people assisting enrollees or acting on their behalf in accordance with all performance standards, policy and procedures, and protocols including but not limited to the confidentiality and privacy policies.
-Track and document all inquiries using the applicable systems.
-Process new applications for health care coverage via the telephone including building tax household, household income, eligibility determinations, interpreting determinations made by the Marketplace, and enrollment into health plans. Transfer/refer consumers to appropriate entities according to the established guidelines.
-Process life event changes, demographic updates, disenrollment requests, and special enrollment periods as requested.
-Facilitate the fulfillment of caller requests for materials via mail, email, or download.
-Facilitates translation services for non-English speaking callers according to procedures.
-Escalate calls or issues to the appropriate designated staff for resolution as needed.
-Attends meetings and trainings as requested and maintains up-to-date knowledge of all programs and systems.
This is the corporate approved job titling framework criteria. Please see the job summary for Project Specific position requirements.