Sr. Customer Service Representative (Hybrid-Remote)

Job Introduction

Maximus is currently hiring for a Sr. Customer Service Representative position! This position provides telephonic assistance to the Complaints Unit at the State Department of Health. This position will require reviewing allegations of managed care organization (MCO) non-compliance with regulatory, statutory, and Department of Health program requirements. This position investigates complaints from plan members, advocates, and providers involving the administration and payment of the Medicaid managed care benefit and obtains the information necessary for a thorough investigation. This position is also assigned select processing duties, and additional administrative work. The CSR works in the State Department of Health office. 

 

This is a full time, hybrid remote position. The training for this position will be on-site at our Albany, New York office. 

 

What you will receive:

• Starting pay: $18.75/hr
• Competitive healthcare benefits (medical, dental & vision)
• 401(k) retirement savings
• Paid time off (PTO)
• Holiday pay
• Great work/life balance

Education and Experience Requirements

Primary Responsibilities:

• Interface with and refer complaints and/or inquiries to the appropriate departments, agencies, advocates, and/or client representatives.
• Maintain updated knowledge of managed care as it relates to client supported programs.
• Meet the established processing guidelines, protocols and contract requirements related to complaint processing and the handling of PHI/PII.
• Perform other duties as may be assigned by the Complaint Unit Supervisor and/or Project Management.
• Meet all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position.
• Performs other duties as assigned by management

 

Minimum Requirements:

• High School diploma or equivalent with 1-3 years of experience.
• Handles more complex customer service inquiries and problems via telephone, recording consistent problem areas.
• May respond to email inquiries.
• Customer service is the primary function.
• Calls are non-routine and require deviation from standard screens, scripts, and procedures.
• Handles situations which may require adaptation of response or extensive research according to customer response.
• Uses computerized system for tracking, information gathering, and/or troubleshooting.
• May handle escalated or unresolved calls from less experienced representatives.
• Works on assignments that are moderately difficult, requiring judgement in resolving issues.
• Understands implications of work and makes recommendations for solutions.

 

 

 

 

 

 

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MAXIMUS Introduction

Since 1975, Maximus has operated under its founding mission of Helping Government Serve the People�, enabling citizens around the globe to successfully engage with their governments at all levels and across a variety of health and human services programs. With approximately 30,000 employees worldwide, Maximus is a proud partner to government agencies in the United States, Australia, Canada, Saudi Arabia, Singapore and the United Kingdom. Launch your career with Maximus through one of our dynamic customer service centers.

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential and bring a resiliency and dependability that greatly enhances our workforce. We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country. We are proud of our connections to organizations dedicated to serving veterans and their families. If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member