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The representative will handle inbound and outbound calls to assist consumers with healthcare plan enrollment, eligibility determinations, and demographic updates. They are responsible for documenting inquiries, facilitating translation services, and meeting quality assurance performance metrics.
- Respond effectively to all forms of inbound and outbound contacts.
- Track and document all inquiries using the applicable systems.
- 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. Transfer/refer consumers to appropriate entities according to the established guidelines.
- Process life event changes, demographic updates, disenrollment requests, and special enrollment periods as requested.
- 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.
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