Eligibility Service Representative - Korean
About the role
Brighton Health Plan Solutions (BHPS) is seeking an Eligibility Service Representative (ESR) who are experienced in understanding eligibility, communicating through various multi-channel features such as phone, chat and email, and following workflows to assist in issue resolution. BHPS shall serve as the client’s eligibility vendor and forward eligibility files to health plans, dental vendors and any other vendor the client utilizes. The ESR will confirm, identify and research matters as they relate to eligibility, changes to coverage and participation as well as support the Eligibility & Benefits team. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities and activities may change, or new ones may be assigned at any time with or without notice.
Responsibilities
- receiving and resolving caregiver inquiries.
- Works with the Benefits Enrollment team to review and resolve any eligibility, hours or co-premium issues including follow-up outreach to caregivers
- Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions.
- Demonstrate strong customer service skills, attention to detail, research & analyzation and issue resolution.
- Clarify customer requirements; probe for and confirm understanding of requirements or problem.
- Agent will be responsible for managing caregiver requests within required turnaround time including conducting outreach to internal partners, engaging the support of the Team Leader and Supervisor as necessary.
- Communicate effectively with individuals/teams to ensure high quality and timely expedition of customer requests.
- Participate in activities designed to improve customer satisfaction and business performance.
- Use decision-support tools to answer questions, where needed.
- Ability to use critical thinking to solve complex problems and identify when to escalate to the appropriate department.
- Performs call center functions including handling inbound calls and support projects as directed by the management.
- Maintain broad knowledge of client requirements, procedures and key contacts.
- Support projects and other departments in completing tasks when directed by management.