Customer Success Agent I

Experience Level: At least one year in a call center customer service role. Health/Insurance background is preferred, though not required.

Salary: $20.00 - $22.00 per hour

SUMMARY

Antidote Health's mission is to redefine healthcare by providing affordable, high-quality, accessible care and insurance products. The Customer Success Agent I plays a key role in achieving this mission by delivering exceptional support to our health plan members, telehealth patients, brokers, and providers. We're looking for passionate individuals with experience in customer care, particularly in the health insurance industry to enhance and differentiate the customer experience.

Responsible for providing accurate, timely, and meaningful information to members and customers, ensuring stellar service in accordance with compliance and regulatory guidelines in a fast-paced inbound and outbound phone, chat, and email Customer Support Center.

This is a remote position with multiple shift options.

ESSENTIAL DUTIES AND RESPONSIBILITIES

• Provide service support to members, providers, and/or brokers using one or more contact center communication channels and across multiple states and/or products. To include, but not limited to, phone, chat, email, and off phone work.  
• Build and maintain brand affinity by addressing questions, concerns, and complaints professionally while maintaining confidentiality in compliance with HIPAA guidelines
• Accurately identify and explain Antidote HMO insurance plans, benefits, enrollment processes, EOBs, PCP selection, and referral/authorization for medical services, prescription coverage info, and other ancillary services (dental and vision).
• Accurately and completely document pertinent details related to Member, Provider, or Broker inquiries
• Coordinate and schedule telehealth appointments by effectively utilizing scheduling systems ensuring timely access to care.
• Demonstrate ability to quickly build rapport and respond to customers in an empathetic manner by identifying and exceeding customer expectations
• Capable of meeting/ exceeding individual performance goals established for the position in the areas of: Call Quality, Attendance, Adherence and other Contact Center objectives.
• Ablility to proactively engage and collaborate with varies Internal/ External departments.
• Provides outreach calls to members and customers for issue resolution and follow-up
• Personal responsibility and accountability by taking ownership of providing resolutions in real time or through timely follow up with the customers.
• Ability to work regularly scheduled shifts within our hours of operation, where lunches and breaks are scheduled and work over-time and/or weekends, as needed.
• Process premium payments.
• Identifies, addresses, and documents member and customer complaints, grievances and appeals
• Coordinates translation services for members in accordance with Antidote’s Language Assistance Program.
• Performs other duties as assigned.        
  

QUALIFICATIONS

To perform this job successfully, candidates must excel in each essential task. The requirements listed below represent the necessary knowledge, skills, and abilities. Reasonable accommodations can be made to enable individuals with disabilities to perform the essential functions:

• Good critical thinking with a problem-solving approach.  
• Strong computer and phone skills, attention to detail, and adherence to processes and policies.
• Excellent verbal and written communication skills.
• Strong interpersonal skills.
• Active listening skills to accurately respond to inquiries and requests.
• Exceptional organizational skills, with the ability to retain and recall policies and processes.
• Bilingual in Spanish is preferred.
  

EDUCATION AND EXPERIENCE

• Experience with Google Workspace, Microsoft Office Suite, and internal communication systems such as Slack or Microsoft Teams.
• Minimum one year of related experience in a high-volume phone, email, and text messaging call center.
• Call center experience in the health insurance industry is preferred.
• Salesforce experience is preferred.
  

CERTIFICATES, LICENSES, REGISTRATIONS

• A Health Agent license is a plus but not required.

WORK ENVIRONMENT

• This is a remote position.
• Must have a quiet, distraction-free workspace to perform duties effectively from home.
• Work location must be secure and private to maintain HIPAA compliance.
• Office equipment will be supplied.
• This position does not require travel.

TRAINING EXPECTATIONS

• You will attend a minimum 4-5 week remote training program.
• Attendance is mandatory for the full training program.
• Training hours: Monday through Friday, 9:00 AM - 4:30 PM EST
• You will be required to take regular open-book competency and retention exams during all weeks of training, with a passing grade of 90% or above.
• We request no time off within the first 120 days of employment except in emergencies. If approved, any time off within this period will be unpaid.
  

WORK SHIFTS AVAILABLE

• Shift flexibility is required. Shift availability is based on staffing needs, with no guaranteed shifts.
• Available Full-Time shift options:
  1. Sunday - Thursday
  2. Tuesday - Saturday
     • Morning shift: 8:00 AM - 5:00 PM EST
     • Mid-shift: 12:00 PM – 8:00 PM EST