Project Specific Job Summary:
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.
- 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.
- 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.
- Process life event changes, demographic updates, disenrollment requests, and special enrollment periods as requested.
- Transfer/refer consumers to appropriate entities according to the established guidelines.
- Perform co-browse interactions with consumers seeking assistance with the application process via the NYSOH, as necessary
- Facilitate the fulfillment of caller requests for materials via mail, email, or download.
- Respond to all inquiries consistent with confidentiality and privacy policies and refers callers to alternate sources when appropriate.
- Escalate calls or issues to the appropriate designated staff for resolution as needed.
- Track and document all inquiries using the applicable systems.
- Facilitate translation services for non-English speaking callers according to procedures.
- Attends meetings and trainings as requested and maintains up-to-date knowledge of all programs and systems.
- Meet Quality Assurance (QA) and other key performance metrics.
- Responsible for adhering to established safety standards.
- Must be able to remain in a stationary position for an extended period of time
- Occasionally lifts, carries, or otherwise moves items weighing up to 25 pounds
- Work is constantly performed in an office environment
- Perform other duties as assigned by management.
Education & Experience Required:
- High School Diploma or GED
- 6 months to 2 years of experience
- Strong data entry and telephone skills;
- Excellent organizational, interpersonal, written, and verbal communication skills;
- Ability to perform comfortably in a fast-paced work environment;
- Ability to successfully execute many complex tasks simultaneously;
- Ability to work as a team member, as well as independently.
- Previous experience with computers, phone systems, and headsets preferred;
- Previous experience in customer service preferred