Hotline Support

Responsibilities

• Perform eligibility and prescription benefit updates; accurately and professionally resolving issues in real time and providing excellent telephone customer service
• Research, update, and follow up on changes such as enrollment and workflows, eligibility and benefit elections in eligibility system (Vitech), PHI, prescription (Express Scripts), dental and call tracking (QNXT) systems
• Data enter enrollment information, relevant membership data, and supporting documentation obtained from various sources such as Member Services, Outreach Department, satellite office - pension codes, employer reports, workers compensation, disability, home mortgage, Cross Fund reports, 1199
  
  SEIU Training and Employment Funds, GNY Spousal Premiums etc
• Communicate with management; keeping them abreast of any member issues that require escalation and report trends via established protocols
• Create various weekly and monthly Excel reports regarding productivity
• Work closely with management in maintaining and reviewing work production
• Provide clerical support to the Eligibility department including but not limited to filing, photocopying, and faxing etc
• Perform additional duties and projects as assigned by management

• High School Diploma or GED required, some College or Degree preferred
• Minimum two (2) years Eligibility systems knowledge/experience (Vitech, QNXT, or ESI) in a health benefits environment required
• Minimum two (2) years customer service experience in a call center environment; or two (2) years’ experience in a member-facing position required
• Comprehensive knowledge of enrollment documentation, eligibility requirements, benefit provisions and enrollment processing required
• Excellent keyboarding skills required (minimum 6,000 KPH and 6% or less error rate)
• Basic skill level in Microsoft Word and Excel preferred, able to perform enrollment data entry analysis and navigate eligibility systems (Vitech V3)
• Excellent customer service and telephone skills a must; able to maintain pleasant and helpful demeanor ensuring professional services are provided
• Ability to work well under pressure, multi-task, establish priorities, meet deadlines, problem solve and follow through on assignments
• Good communication skills (oral and written) and ability to speak in a clear and concise manner
• Available to work overtime preferred
• Must meet performance standards including attendance and punctuality