Customer Service Representative II - Mexico, NY

Description & Requirements

Make a Difference in Your Community Every Day! Maximus is seeking a Customer Service Representative II to join our team in Mexico, NY. In this rewarding role, you will help New York Medicaid recipients navigate their healthcare options, access important services, and make informed decisions about their coverage. As a trusted resource for the community, you will provide both face-to-face and telephone support, guiding individuals through the enrollment process, explaining managed care plan options, and delivering compassionate, people-centered service. By delivering clear, compassionate communication, you will help ensure members have access to the information and support necessary to make informed healthcare decisions. Your ability to communicate will help ensure members receive the support and information they need to access quality healthcare. This is an excellent opportunity for individuals who enjoy helping others, building relationships, and making a meaningful impact in their community. Whether you are starting your customer service career or bringing prior experience, we provide the training and support needed to succeed, including maintaining your Certified Application Counselor (CAC) certification.

Details: • Full-time, onsite position located in Mexico, NY • Monday – Friday schedule, 8:00 AM – 4:00 PM • Comprehensive health and wellness benefits If you are passionate about serving others and seeking a career with purpose, we encourage you to apply today and join a team dedicated to improving the lives of New Yorkers.

Essential Duties and Responsibilities: -    Serve as a subject matter resource for customer inquiries received via telephone, interactive voice response (IVR), web based portals, or outreach activities regarding program information and services. -    Manage and support escalated enrollment cases and processes in accordance with established case resolution procedures. -    Respond to complex or sensitive customer concerns by applying program policies, procedures, and guidelines to determine appropriate actions or referrals. -    Accurately document customer interactions, case activity, outreach efforts, and actions taken in applicable systems. -    Navigate and utilize multiple systems, tools, and data sources to retrieve, review, compare, analyze, and verify customer or program information. -    Conduct outbound contacts to customers to obtain corrections, clarification, or required documentation to support case resolution or enrollment verification. -    Review and compare customer submitted documentation, including income or eligibility materials, against application data to verify accuracy and compliance. -    Apply program knowledge to educate customers on program offerings, eligibility requirements, enrollment options, and available services. -    Support customers throughout multiple phases of the application or service lifecycle, from enrollment through receipt of benefits or services. -    Identify issues, trends, or barriers impacting customer engagement or service delivery and report concerns to management or project staff as appropriate. -    Collaborate with internal teams, client escalation groups, and external partners to support effective resolution of customer issues and project objectives. -    Maintain confidentiality and security of customer, provider, and program information at all times. -    Meet or exceed established productivity, quality assurance, and performance standards. -    Attend required meetings and trainings and maintain up to date knowledge of programs, systems, policies, procedures, and compliance requirements. -    Perform other related duties as assigned by management.

- Conduct face-to-face and/or virtual (telephonic) outreach and enrollment services, including education on managed care options and public health programs to clients at LDSS/HRA offices - Assist clients with