Member Support Representative

About the role

Provides comprehensive support to Fidelis and Wellcare members by addressing inquiries, conducting outreach, and assisting with enrollment in various health plans, including Medicaid, Medicare, and other Fidelis Care products. This role requires in-depth product knowledge, consultative selling, and the ability to facilitate access to services to ensure member satisfaction and retention.

Responsibilities

• Identifies prospective enrollees and determines eligibility for participation in the Advantage Medicare product
• Assists members in accessing health care, transportation needs and other services or issues as they occur and pertain to members
• Answers application and service-related questions about Fidelis and Wellcare programs, helping to maintain and attract membership
• Researches, analyzes, and documents member inquiries regarding program eligibility
• Conducts outreach and follow-up calls to educate members on Wellcare products, acting as a liaison between members and various Fidelis and Wellcare departments
• Accurately documents all interactions in Salesforce and other relevant systems
• Gains and maintains thorough knowledge of Fidelis Care products, including options available through the New York State of Health (NYSOH), Medicaid Managed Care, Child Health Plus, Medicare, MLTC, FIDA, and HARP
• Attends and participates in sales meetings, training programs, conventions, and special events
• Performs other duties as assigned
• Complies with all policies and standards

Requirements

• High School Diploma, GED or equivalent required
• 1+ years marketing, sales or community relations experience, customer service including previous experience, in Healthcare preferably Medicare and/or Medicaid required

Qualifications

• State Accident and Health Insurance Agent License to be obtained within 60 days of hire
• Current state driver's license required upon hire

Skills

• Bilingual; Spanish highly preferred (English/Spanish/Cantonese or Mandarin also noted)
• Experience with Medicare/Medicaid sales and community engagement highly preferred
• Understands covered benefits, non-covered benefits, exclusions and exemptions
• In-depth product knowledge and consultative selling ability
• Ability to facilitate access to services to ensure member satisfaction and retention

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays

Pay

$19.43 - $32.9