Customer Service Representative II - Canandaigua, NY

About the Role

Maximus is seeking a Customer Service Representative II to join our team in Canandaigua, NY. In this role, you will assist New York Medicaid recipients in navigating their healthcare options, accessing services, and making informed decisions about their coverage. You will provide face-to-face and telephone support, guide individuals through enrollment, explain managed care plans, and deliver compassionate service. This position is ideal for those passionate about helping others and making a meaningful community impact.

Responsibilities

• Serve as a subject matter resource for customer inquiries via telephone, IVR, web portals, or outreach activities.
• Manage and support escalated enrollment cases following established procedures.
• Respond to complex or sensitive customer concerns by applying program policies and guidelines.
• Accurately document customer interactions, case activity, and actions taken in applicable systems.
• Navigate multiple systems to retrieve, review, and verify customer or program information.
• Conduct outbound contacts to obtain corrections, clarifications, or required documentation.
• Review and compare customer-submitted documentation for accuracy and compliance.
• Educate customers on program offerings, eligibility, enrollment options, and services.
• Support customers throughout the application and service lifecycle.
• Identify and report issues, trends, or barriers impacting customer engagement or service delivery.
• Collaborate with internal teams, escalation groups, and external partners to resolve customer issues.
• Maintain confidentiality and security of customer, provider, and program information.
• Meet productivity, quality assurance, and performance standards.
• Attend required meetings and trainings; stay updated on programs, policies, and compliance.
• Conduct face-to-face and virtual outreach and enrollment services, including education on managed care options.
• Assist clients with enrollment, transfer, and disenrollment processes.
• Maintain professional relationships with county staff and clients.
• Support Call Center Operations and other departments as needed.
• Conduct shadowing and training activities for new hires.
• Work on assigned special projects.
• Maintain Certified Application Counselor (CAC) certification.
• Perform CAC tasks in select counties.
• Meet standards outlined in the annual performance criteria and bonus template.

Requirements

• High school diploma or GED required.
• 6+ months of relevant professional experience, or equivalent combination of education and experience.
• Prior work experience in customer service, data entry, and/or data processing.
• Experience with MS Office applications (Excel, PowerPoint, Word).

Qualifications

• Some college or college degree (preferred).
• Experience with New York Medicaid (preferred).
• 2+ years of experience in customer service or related position (preferred).
• Ability to follow established guidelines while maintaining a proactive approach.
• Effectively manage multiple tasks and priorities under pressure.

Home Office Requirements (For 2 Weeks of Remote Training)

• Own laptop/computer with Windows 11 or MacOS 13 Ventura or higher.
• Private and secure workspace.
• Reliable high-speed internet service.
• Minimum 20 Mbps download speeds (50 Mbps for shared connectivity).
• Minimum 5 Mbps upload speeds.

Benefits

• Comprehensive health and wellness benefits.
• Competitive compensation with performance-based bonuses.
• Flexible work/life balance support.
• Various insurance plans: Medical, Dental, Vision, Prescription, and partially funded HSA.
• Life insurance and discounts on Auto, Home, Renter's, and Pet insurance.
• 401K Retirement Savings plan with Company Matching.
• Paid Time Off (PTO), Holidays, and extended sick leave.
• Short and Long Term Disability coverage.
• Employee Assistance Program (EAP) for holistic wellness support.
• Recognition platform for outstanding contributions.
• Tuition reimbursement for ongoing education.
• Employee perks and discounts.
• Access to Maximus Wellness Program and resources.
• Professional development opportunities, including training and conferences.

Pay

Minimum Salary: $18.00
Maximum Salary: $20.50

Schedule

Full-time, onsite position
Monday – Friday, 8:00 AM – 4:30 PM