Amida Care · 1 day ago
Member Services Representative
New York, NY, US
Full-time
Onsite
Entry Level
1+ years expAmida Care, the largest Medicaid HIV Special Needs Plan in NY, is seeking a highly motivated Member Services Representative to support their mission of delivering top-notch customer service to members and providers. This role involves handling a high volume of inquiries regarding benefits, services, and claims, while also conducting outreach and educational initiatives for members.
Child CareHealth CarePharmaceutical
Responsibilities
Answer members and provider inquiries concerning plan benefits, claims and complaints
Escalating complex and urgent member-care needs to the appropriate Management or departments
Transfer members to Amida Care’s Partners for Services provided on behalf of Amida Care
Navigate different systems and databases to resolve members’ issues or concerns
Document all conversations/touchpoints in the Amida Care system (Salesforce)
Meet Quality Assurance requirements and other call center key performance metrics
Collect and document prospective members information the Amida Care system (Salesforce)
Conduct outbound calls for projects and member outreach follow–ups
Confirm and update member contact information and demographic, such as address, phone numbers & Primary Care Provider etc
Promote and educate members on plan benefits, services, programs, alerts, and reminders
Conduct New Member Orientation as assigned
Utilize translation line as needed to communicate with members
Attend key member events as assigned by Management
Provide feedback to management teams on any trending member inquiries and/ or activities for process improvement
Perform other duties as assigned
Qualification
Required
High School Diploma or equivalent combination of education and relevant work experience required
Minimum One (1) years' experience in Customer Service
Must be able to maintain strict confidentiality of sensitive member's information (HIPAA)
Proficiency in Microsoft Office (Word, Excel)
Strong verbal and written communication skills
Ability to sit for an extended period-of- time
Ability to manage multiple tasks and work consistently in a fast-paced environment
Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts
Demonstrate appropriate behaviors in accordance with the organization's vision, mission, and values
Company
Amida Care
Amida Care is an organization providing healthcare, meals, advocacy, research and social services.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Doug Wirth
President/CEO
Alex Fontanez
Associate Director of Partnerships & Ombudsman
Recent News
2025-11-19
Company data provided by crunchbase