Monica Lin

The Consumer Relations Representative (CRR) is responsible for answering phone inquiries from consumers including but not limited to general information, as well as assisting individuals and families in applying for health care coverage through the New York State of Health (NYSOH) Medicaid Eligibility Client Management System.

• Provide customer services via telephone to clients regarding the selection, enrollment, and eligibility requirements for various contract programs.

• Provide callers with an unbiased presentation of programs to assist customers with application and eligibility requirements.

• Document all customer encounters in clear, concise records.

• Multi-task by simultaneously communicating with the client while researching their case and documenting the call.

• Access, read, and interpret data elements on all applicable MAXIMUS, Project, and State systems to provide support, resolve inquiries, and educate consumers.

• Maintain updated knowledge of the program, including its policies and procedures as referenced in the employee manual and other policies adopted by corporate, the project, and/or client.

• Process new applications for health care coverage via telephone, including building households, household income, eligibility determinations, interpreting determinations made by the eligibility system, and enrollment into health plans.

• Process life event changes, demographic updates and disenrollment requests as requested.

• Facilitate the fulfillment of caller requests for materials via mail, email, or download.

• Respond to all inquiries consistent with confidentiality and privacy policies and refer callers to alternate sources when appropriate.

• Facilitate translation services for non-English speaking callers according to procedures.

• Attend meetings as requested and maintain up-to-date knowledge of all programs and systems.

• Meet Quality Assurance (QA) and other key performance metrics.

• Adhere to established safety standards.

• Remain in a stationary position for an extended period of time

• The Bilingual Customer Service Representative is responsible for answering inquiries from Marketplace individual consumers including but not limited to general information as well as assisting individuals and families in applying for health care coverage through the Marketplace

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Answer incoming calls from consumers including the general public, prospective enrollees and people assisting enrollees or acting on their behalf in accordance with all performance standards, policy and procedures, and protocols

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Process new applications for health care coverage via the telephone including building tax household, household income, eligibility determinations, interpreting determinations made by the Marketplace, and enrollment into health plans

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Process life event changes, demographic updates, disenrollment requests, and special enrollment periods as requested

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Transfer / refer consumers to appropriate entities according to the established guidelines

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Perform co-browse interactions with consumers seeking assistance with the application process via the NYSOH, as necessary

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Facilitate the fulfillment of caller requests for materials via mail, email, or download

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Respond to all inquiries consistent with confidentiality and privacy policies and refers callers to alternate sources when appropriate

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Escalate calls or issues to the appropriate designated staff for resolution as needed

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Track and document all inquiries using the applicable systems

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Facilitate translation services for non-English speaking callers according to procedures

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Attends meetings and trainings as requested and maintains up-to-date knowledge of all programs and systems

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Meet Quality Assurance (QA) and other key performance metrics

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Responsible for adhering to established safety standards

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Work is constantly performed in an office environment

• Handled unsatisfied customers and difficult cases with poise and calmness, avoiding escalating situations.
• Provided personalized customer service to help build strong and lasting client relationships.
• Retained detailed records of customer interactions, transactions and complaints.
• Provided customers with availability, pricing and shipping information to expedite orders.
• Resolved problems to maintain professional relationships with internal and external customers.
• Delivered strong support and mitigated issues to improve overall customer satisfaction.
• Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
• Engaged in conversation with customers to understand needs, resolve issues and answer product questions.
• Collected deposits or payments and arranged for billing.
• Adjusted bills and refunded money to resolve customers' service or billing complaints.
• Promoted available products and services to customers during service, account management and order calls.

• Unboxed new merchandise and restocked shelves in appealing and organized arrangements to promote items.
• Performed floor moves, merchandising, display maintenance and housekeeping to keep sales areas well-stocked, organized and current.
• Completed sales transactions and processed merchandise return, maintaining proper accountability of register.

• Checked on guests to verify satisfaction with meals and suggested additional items to increase restaurant sales.
• Greeted customers, answered questions and recommended specials, wine and desserts to increase profits.
• Maintained knowledge of menu items, garnishes, ingredients and preparation methods to assist guests with menu selection.
• Trained and acclimated new servers to restaurant's culture and operations.