[Remote] Eligibility Service Representative - Mandarin/Cantonese Speaking

Note: The job is a remote job and is open to candidates in USA. Brighton Health Plan Solutions is seeking an Eligibility Service Representative who is experienced in understanding eligibility and communicating through various multi-channel features. The role involves assisting in issue resolution related to eligibility, changes to coverage, and supporting the Eligibility & Benefits team.

Responsibilities

• The ESR will be responsible for receiving and resolving caregiver inquiries
• Works with the Benefits Enrollment team to review and resolve any eligibility, hours or co-premium issues including follow-up outreach to caregivers Listen attentively to customer needs and concerns; demonstrate empathy and offer solutions
• Demonstrate strong customer service skills, attention to detail, research & analyzation and issue resolution
• Clarify customer requirements; probe for and confirm understanding of requirements or problem
• Agent will be responsible for managing caregiver requests within required turnaround time including conducting outreach to internal partners, engaging the support of the Team Leader and Supervisor as necessary
• Communicate effectively with individuals/teams to ensure high quality and timely expedition of customer requests
• Participate in activities designed to improve customer satisfaction and business performance
• Use decision-support tools to answer questions, where needed
• Ability to use critical thinking to solve complex problems and identify when to escalate to the appropriate department
• Performs call center functions including handling inbound calls and support projects as directed by the management
• Maintain broad knowledge of client requirements, procedures and key contacts
• Support projects and other departments in completing tasks when directed by management

Skills

• Bilingual in Russian/English or Korean/English
• Flexible availability for alternate schedules/hours, including shifts between 11AM and 9PM EST, Monday through Friday, with training from 9AM to 6PM
• Experience in high-volume enrollment and eligibility transactions, premium billing, and collections
• Knowledge of labor and commercial carrier enrollment procedures
• Prior high-volume call center experience
• General knowledge of HIPAA Confidentiality
• High School diploma or GED
• Remote work capability with internet access
• Basic computer skills, including Microsoft Office (Word, Excel, Access, PowerPoint, Outlook)
• Strong investigative and time management skills
• Courteous and customer-service oriented
• Detail-oriented and dependable
• Effective communication through multiple channels (email, chat, voice)
• Preferred experience in enrollment/eligibility roles, especially in commercial and labor plans
• Previous multi-channel experience (voice, email, chat) is a plus
• Some college or business school education is advantageous

Company Overview