Roles and Responsibilities:

The Tier I Customer Service Representatives roles and responsibilities include but are not limited to the following:

• Documenting all consumer interactions and work processes in State-provided Customer Relationship Management (CRM) solution and the MHC worker portal
• Providing information about QHP, SADP and Medicaid/MCHP Managed Care Organizations (MCOs) offerings
• Informing consumers how to make premium payments to carriers
• Assisting Medicaid eligible consumers in selection of a MCO and choosing a Primary Care Provider (PCP).
• Follow MDH MCO scripts precisely
• Assisting Medicaid eligible consumers in completing a Health Service Needs Information (HSNI) form
• Responding to inquiries related to eligibility status, enrollment status, coverage dates and change in circumstances
• Researching and resolving or escalating consumer issues and account discrepancies
• Assisting and educating consumers on appeal and complaint processes; properly escalating when necessary
• Assisting Medicaid-eligible consumers with Annual Right to Change (ARC) requests for MCO Enrollment
• Assisting Medicaid eligible consumers with transfers between MCOs if disenrolled “For Cause” reasons.
• Answering questions and assisting with problems related to 1095A and 1095B forms
• Providing assistance with password resets (tech support)
• Provide referrals to appropriate agencies including the Attorney General’s Health Education and Advocacy Unit, the MIA, and local departments of social services for applicants and enrollees with grievances, complaints, questions, or the need for other social services.
• Providing consumers assistance in navigating the web portal, assisting with enrollment and financial assistance eligibility, and comparing health and dental plans
• Other duties as assigned

Qualifications:

• At least three (3) years of relevant experience required
• Proficiency in MS Word
• Willingness to work with culturally and linguistically diverse and disadvantaged populations in a courteous and effective manner
• Must be able to navigate and efficiently use customer relationship management (CRM) and Maryland Health Connection (MHC) systems
• Effective communication skills
• Ability to perform comfortably in a fast-paced environment
• EDUCATION: High school diploma or GED required with at least 3 years of relevant experience required. Associates degree or higher from an accredited college or university preferred

Desired Skills:

• Strong interpersonal and leadership skills with the ability to interact with internal/external customers and across organizational elements.
• Demonstrated teamwork skills.
• Excellent verbal and written communication skills –
• Superior problem solving and critical thinking skills
• Excellent organizational, interpersonal, written, and verbal communication skills
• Must complete a Background Investigation

Job Type: Contract

Salary: $15.00 - $18.00 per hour

Schedule:

• 8 hour shift
• Monday to Friday

Work Location: Remote

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