Company Statement
EmblemHealth is one of the nation’s largest not for profit health insurers, serving members across New York’s diverse communities with a full range of commercial and government-sponsored health plans for employers, individuals, and families. With a commitment to value-based care, EmblemHealth partners with top hospitals and doctors, including its own AdvantageCare Physicians, to deliver quality, affordable, convenient care. At over a dozen EmblemHealth Neighborhood Care locations, members and non-members alike have access to community-based health and wellness guidance and resources. For more information, visit emblemhealth.com.
Call Center Professionals - Farmington, Connecticut
🔍 Connecticut
*** Must be able to commute to work location at 195 Scott Swamp Road, Farmington, CT 06302***
We are seeking dynamic Call Center Professionals to join our Call Center in Farmington, CT starting July 2025 or August 2025!
Our Call Center professionals provide telephonic customer service support to members, providers and facilities. Handle incoming inquiries through multiple contact channels and effectively and efficiently communicate resolutions to members' requests ensuring high First Contact Resolution. The Call Center team advocates for our members in the event there are issues and follows up with the members once the issues are resolved.
If you believe in extraordinary commitment to customer service, come join us!
***All positions are on-site at 195 Scott Swamp Road, Farmington, CT 06302***
Essential Job Information:
- Up to 8 weeks of in-classroom training onsite
- Primarily sedentary
Compensation and Benefits:
- Hourly Pay Rate is $19.23
- We offer competitive health and wellness benefits
Job Responsibilities:
- Proactively receive and respond clearly to telephone calls and correspondence from members regarding billing, benefits, coverage, payment, coding, and health services policies and procedures.
- Demonstrate a customer service attitude on the initial call with a commitment to resolve customer issues including claims, benefit and enrollment inquiries through health plan navigation and collaboration with other internal groups.
- Function as a scheduling agent, working in collaboration with the member, to ensure appointments are scheduled, as necessary.
- Maintain telephone log documenting number, content and type of calls received.
- Explain medical pre-authorization requirements and disposition of pre-authorization requests, as necessary.
- Research and analyze recurring billing and eligibility problems/complaints to determine root causes and trends.
- Provides instruction to members for submitting out-of-plan medical claims.
- Investigate requests for claims adjustments by members and collaborates with internal teams to ensure adjustments are made.
- Inform and educate members on how to utilize self service capabilities and functionality with the portals and mobile application.
- Gather and proactively provide feedback to stakeholders based on member feedback to further improve customer experience.
Required Qualifications:
- High School degree or equivalent
- Up to 2 years of customer service experience
- Microsoft office experience; with keyboarding and basic computer proficiency
- Strong customer service skills
- Excellent written and communication skills
- Strong problem-solving and multi-tasking skills
- Ability to collaborate and work effectively within a team environment
Preferred Qualifications:
- Associate or higher degree
- Up to 2 years of call center experience in healthcare industry
- Bi-lingual Spanish
Security Disclosure
If you receive a job offer from EmblemHealth, the email will be from “HRTalentAcquisition” with the subject: “Offer of Employment for (job title) – Please respond online.” We will never ask you to join a Google Hangout, buy your own equipment, or pay to apply. We also do not use third-party email services like Yahoo or Gmail.
Pay Disclosure
At EmblemHealth, we prioritize transparency in our compensation practices. We provide a good faith estimate of the salary range for potential hires, which is based on key factors such as role responsibilities, candidate experience, education and training, internal equity, and market conditions. Please be aware that this estimate doesn’t account for geographic differences related to your work location. Typically, new hires may not start at the top of this range, as compensation is tailored to each individual's circumstances. For union positions, salaries will be determined according to the collective bargaining agreement. Join us at EmblemHealth, where your contributions are valued and supported by fair compensation.
EEOC Statement
We value the diverse backgrounds, perspectives, and experiences of our workforce. As an equal opportunity employer, we consider all qualified applicants for employment regardless of race, color, religion, sex, sexual orientation, gender identity, pregnancy, marital status, national origin, disability, veteran status, or any other protected characteristic protected by law.
Sponsorship Statement
EmblemHealth may provide work visa sponsorship depending on factors such as business unit requirements, position nature, costs, and applicable laws and regulations.