Customer Service Representative

Job Title: Customer Success Specialist
Location: New York, NY,
Duration: 08/03/2026 - 09/26/2026
Pay Range: $21-$22/hr.
Shift: 9:00 AM - 5:00 PM ( Hybrid)
Schedule: 5 days per week, 35 hours per week (Hybrid - Thursdays mandatory)
Schedule Notes: Orientation is the first full week. Role involves assisting all lines of business (Medicaid, Medicare, MLTC, CHP, EP) in retaining current qualified members by following a strategic daily schedule that includes morning and evening hours, field locations, and occasional weekends. Responsibilities include recertification/renewal of membership, assisting with enrollment activities, PCP selection, locating providers/vendors within the plan network, and supporting member retention and satisfaction through communication, process improvement initiatives, and collaboration with internal and external stakeholders.


Required Education, Training & Professional Experience

• Associate's Degree and minimum 1 year of experience in direct consumer contact, including customer engagement, customer services, sales, community engagement; OR
• High school degree and 3-5 years of experience in direct consumer contact, including customer engagement, customer services, sales, community engagement.
• Bi-lingual preferred.

Licensure & Certification Required

• Candidate must obtain Certified Application Counselor (CAC) certification within the first month of employment. Client will facilitate training and certification.

Professional Competencies

• Functional/Technical skills.
• Highly organized with attention to detail.
• Integrity and trust.
• Customer Experience Focus.
• Ability to collaborate with different stakeholders.
• Written and Oral Communication skills.
• Conflict Resolution.
• Patience.
• Problem-solving skills.

Position Overview
Empower. Unite. Care.
Client is committed to empowering New Yorkers by uniting communities through care. We believe healthcare is a right, not a privilege. The Customer Success Specialist supports Client members and other key stakeholders across the customer's journey. Specialists are experts on the system and understand NYSOH processes to quickly route members to the appropriate resolution and support. The Specialist will act as a liaison to ensure proper processes are introduced and implemented to enhance the Client experience. They provide excellent customer experience, resulting in member retention through both inbound and outbound outreach, and serve as a single point of contact for all department-directed issues.


Product of Role & Responsibilities

• Recertification/renewal of membership.
• Assist all lines of business (Medicaid, Medicare, MLTC, CHP, EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours, field locations, and weekends.
• Follow appropriate processes to meet and exceed recertification Clients set by the department.
• Make the recertification process as easy and seamless as possible for members.
• Assist members with completion of recertification applications.
• Partner with different parts of the organization to understand any barriers to the member's experience and work to resolve them appropriately.
• Maintain daily outreach and renewal goals to increase overall retention.
• Enrollment and retention support.
• Assist members with completion of all enrollment activities, including changing lines of business, re-enrollment due to administrative issues, and premium payment.
• Assist members with PCP selection and locating providers/vendors within the plan's network.
• Provide end-to-end customer support to drive customer satisfaction and improve member experience.
• Interface with internal and external stakeholders to ensure complete resolution.
• Communicate verbally and in writing with members for all necessary Member Retention activities.
• Process improvements: devise solutions in response to member dissatisfaction, complaints, or issues to support ongoing organizational improvement efforts.
• Support ad hoc projects on process improvements.
• Report common trends identified during member outreach.

Other duties as assigned.