Customer Service Representative, West New York

Position Overview
The Customer Success Specialist I supports Client members and key stakeholders throughout the customer journey.
This role serves as a subject matter expert on Client processes and acts as a liaison to ensure members receive timely resolutions and support.
The ideal candidate is customer-focused, detail-oriented, and passionate about delivering an exceptional member experience that drives retention and satisfaction through both inbound and outbound outreach.
The Customer Success Specialist I will oversee member retention activities and serve as a single point of contact for issues escalated to the Customer Success department.
Key Responsibilities
Membership Recertification & Renewal
Support retention efforts across all lines of business including Medicaid, Medicare, MLTC, CHP, and EP
Conduct outbound member outreach using strategic schedules, including morning/evening hours and weekends when needed
Guide members through recertification and renewal processes
Assist with completion of recertification applications
Meet daily outreach and renewal goals
Collaborate with internal departments to resolve barriers impacting the member experience
Enrollment & Retention Support
Assist members with enrollment activities and plan transitions
Support re-enrollment due to administrative issues
Help members with premium payments, PCP selection, and locating providers/vendors within the network
Deliver end-to-end customer support to improve member satisfaction
Communicate effectively with members verbally and in writing
Coordinate with internal and external stakeholders to ensure complete issue resolution
Process Improvement
Identify and report trends from member interactions
Recommend solutions for member complaints and dissatisfaction
Participate in process improvement initiatives and special projects
Perform additional duties as assigned
Qualifications
High school diploma or equivalent required
Strong customer service and communication skills
Ability to manage multiple tasks and priorities in a fast-paced environment
Experience working with diverse populations preferred
Bilingual language skills highly preferred
Benefits:
Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.