Description

Make a Difference in Your Community Every Day! 

Maximus is seeking a Customer Service Representative I to join our team in Rochester, 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 Rochester, NY 
• Monday – Friday schedule, 8:00 AM – 4:30 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.

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:

• Coordinate and process intake referrals received via incoming calls, voicemail, email, or other designated channels
• Respond to inquiries, provide general program information, and refer clients or providers to appropriate agencies or resources in accordance with established guidelines
• Perform initial eligibility screening for services using defined criteria and procedures
• Review and screen applications and supporting documentation for completeness and accuracy
• Enter, update, and maintain application, intake, and case information in applicable databases and systems
• Research, verify, and document information by accessing approved internal or external systems, including government agency systems as applicable
• Contact customers or providers to obtain missing or incomplete information related to applications or documentation
• Coordinate with internal staff or field resources, including site visit personnel, to collect and verify required information or results
• Assist customers in accessing services aligning with specific program objectives including educational and vocational training, medical support, childcare, transportation, mental health services, legal aid and related needs
• Determine urgency and sensitivity of incoming matters and route or escalate appropriately
• Support outreach and engagement activities by assisting customers through defined phases of the application, enrollment, or service process
• 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 0-6 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
• Minimum 5 Mpbs upload speeds