Description & Requirements
Answer inbound calls providing education, enrollment, and helpline services. Document all calls received in State or Project systems. Process enrollment forms received, make call backs, process other mail. Report system issues, concerns, or discrepancies.
Essential Duties and Responsibilities:
- 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 including but not limited to the confidentiality and privacy policies.
- Respond effectively to all forms of inbound and outbound contacts.
- Track and document all inquiries using the applicable systems.
- Transfer/refer consumers to appropriate entities according to the established guidelines.
Facilitate the fulfillment of caller requests for materials via mail, email, or download.
- Facilitate translation services for non-English speaking callers according to procedures.
- Escalate calls or issues to the appropriate designated staff for resolution as needed.
- Attend meetings and trainings as requested and maintain up-to-date knowledge of all programs and systems.
1) Responds to enrollment, eligibility, or helpline services calls and questions, may respond to e-mail inquiries; mails information in response to requests, and refers callers or their concerns to the appropriate department and documents the call in the appropriate systems.
2) Educates beneficiaries on managed care or other DCH programs.
3) Verifies enrollment and case information in CRM, Champs, and MAXeb. Maintains updated knowledge of plans and providers that are available to beneficiaries.
4) Assists beneficiaries in enrolling/disenrolling in plans, and in selecting a Primary Care Provider, including entering enrollments into the appropriate system. Answer's caller questions about completing applications.
5) Ability to deviate from standard screens, scripts, and procedures as needed with certain calls
6) Communicates more complex information, using job experience to anticipate and proactively address related questions.
7) Reviews enrollment forms for accuracy and completeness.
8) Sends necessary letters to beneficiaries.
9) Maintains updated knowledge of the project.
10) Assists with on-the-job training for employees as necessary.
11) Raises issues of concern and/or problems to the attention of the Lead Client Service Representative, Supervisor, or Call Center Manager.
12) Performs other duties as may be assigned by management.
Minimum Requirements
Minimum Requirements:
- High school diploma or GED required and 6+ months of relevant professional experience required, or equivalent combination of education and experience. Education Required / Preferred: High School diploma, GED or equivalent certification. Associates degree or higher preferred. In lieu of degreed program, we will accept equivalent in education and/or experience. Skills / Knowledge Required: Knowledge of the community to be served; excellent organizational, written, and verbal communication skills; proficiency with computer applications, including Microsoft Office. Skills / Knowledge Preferred: Knowledge of state and federal managed care programs; experience in health care, human services, and fluency in commonly spoken languages. Experience Required: 6 months - 2 years of experience with MI Enrolls Call Center OR 6 months - 2 years of experience with helpline services calls, human services, enrollment, and/or customer service. May have additional training or education in area of specialization. Experience Preferred : At least one year of experience with MI Enrolls Call Center, education or experience in providing customer service to low-income populations or children; two years of human services experience.
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're 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 of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you. A committed and diverse workforce is our most important resource. Maximus is an Affirmative Action/Equal Opportunity Employer. Maximus provides equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status or disabled status.
