Customer Service Representative II - Lowville, NY

Make a Difference in Your Community Every Day! Maximus is seeking a Customer Service Representative II to join our team in Lowville, 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. Position Details: Full-time, onsite position located in Lowville, NY Monday - Friday schedule, 8:00 AM - 4:30 PM Comprehensive health and wellness benefits Why Maximus? Work/Life Balance Support Flexibility tailored to your needs! Competitive Compensation Bonuses based on performance included! Comprehensive Insurance Coverage Choose from various plans, including Medical, Dental, Vision, Prescription, and partially funded HSA. Additionally, enjoy Life insurance benefits and discounts on Auto, Home, Renter's, and Pet insurance. Future Planning Prepare for retirement with our 401K Retirement Savings plan and Company Matching. Paid Time Off Package Enjoy PTO, Holidays, and extended sick leave, along with Short and Long Term Disability coverage. Holistic Wellness Support Access resources for physical, emotional, and financial wellness through our Employee Assistance Program (EAP). Recognition Platform Acknowledge and appreciate outstanding employee contributions. Tuition Reimbursement Invest in your ongoing education and development. Employee Perks and Discounts Additional benefits and discounts exclusively for employees. Maximus Wellness Program and Resources Access a range of wellness programs and resources tailored to your needs. Professional Development Opportunities: Participate in training programs, workshops, and conferences. 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 the enrollment/transfer/disenrollment process. Interface and maintain professional and positive relationships with HRA/LDSS county staff and clients. Assist Call Center Operations and other departments as determined by project management to meet business needs. Regular member of a processing unit within the Outreach department: EEU. Data Entry. Manual Notices. Conduct shadowing / training activities with new hires. Works in assigned special projects. Maintain Certified Application Counselor CAC active certification. Conduct Certified Application Counselor (CAC) tasks in select counties. Maintain updated knowledge of the New York Medicaid Choice Project. Meet all standards established for this position as outlined in the corresponding annual performance criteria and bonus template for this position. Perform other duties as assigned by Management. Minimum Requirements High school diploma or GED required and 6+ months of relevant professional experience required, or equivalent combination of education and experience. Prior work experience in customer service, data entry and/or data processing. Experience working with MS office applications (Excel, PowerPoint & Word). Preferred Requirements Some college or college degree. Experience with New York Medicaid. 2+ years of experience in customer service or related position. Follows established guidelines and directions while maintaining a proactive approach to meeting objectives and deadlines. Effectively manages multiple tasks and priorities under pressure, ensuring high-quality outcomes in a fast-paced environment. Home Office Requirements for 1 to 2 weeks of remote training Candidates must have their own laptop/computer equipment with Windows 11 Operating System or MacOS 13 Ventura or higher. Private and secure workspace. Reliable high-speed internet service. * Minimum 20 Mpbs download speeds/50 Mpbs for shared internet connectivity * M #J-18808-Ljbffr