Sr. Customer Service Representative - Albany, NY

Description & Requirements

Maximus is currently looking for a Sr.

Customer Service Representative to join our growing team.

This position is responsible for providing response to inbound inquiries from New York State providers regarding unpaid claims and other billing-related concerns.

This is an onsite position located in Albany, New York.

Why Maximus?

•Starting pay: $19/hour
Work/Life Balance Support - Flexibility tailored to your needs!
• Competitive Compensation - Bonuses based on performance included!
•Comprehensive Insurance Coverage - Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA.

Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance.
• Future Planning - Prepare for retirement with our 401K Retirement Savings plan and Company Matching
• Paid Time Off Package - Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage.

• Holistic Wellness Support - Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP).
• Recognition Platform - Acknowledge and appreciate outstanding employee contributions.

• Tuition Reimbursement - Invest in your ongoing education and development.

• Employee Perks and Discounts - Additional benefits and discounts exclusively for employees.

• Maximus Wellness Program and Resources - Access a range of wellness programs and resources tailored to your needs.

•Professional Development Opportunities: Participate in training programs, workshops, and conferences.

Essential Duties and Responsibilities:

- Interface with clients and refer complaints or inquiries to appropriate departments, agencies, advocates, or client representatives.

- Stay updated on managed care relevant to supported client programs.

- Adhere to processing guidelines, protocols, and contract requirements for complaint processing and handling PHI/PII.

- Assist consumers in health plan enrollment, disenrollment, and transfers when necessary.

- Fulfill assigned duties directed by the Complaint Unit Supervisor or Project Management.

- Meet performance standards outlined in the annual criteria and bonus template for the position.

- Address complex customer service inquiries and problems over the telephone, noting consistent issues for resolution.

- Potentially respond to email inquiries.

- Prioritize customer service as the primary function, handling non-routine calls requiring deviation from standard procedures.

- Manage situations needing adapted responses or extensive research based on customer needs.

- Utilize computerized systems for tracking, information gathering, and troubleshooting.

- Handle escalated or unresolved calls from less experienced representatives.

- Tackle moderately difficult assignments, exercising judgment in issue resolution and recommending solutions.

- Maintain updated knowledge of managed care as it...