Eligibility Service Representative, Korean

About the Role

Brighton Health Plan Solutions (BHPS) is seeking an Eligibility Service Representative (ESR) experienced in understanding eligibility, communicating through various multi-channel features (phone, chat, and email), and following workflows to assist in issue resolution. The ESR will confirm, identify, and research matters related to eligibility, changes to coverage, and participation, and will support the Eligibility & Benefits team.

Key Responsibilities

• Receive and resolve caregiver inquiries.
• Work with the Benefits Enrollment team to review and resolve 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 & analysis, and issue resolution.
• Clarify customer requirements; probe for and confirm understanding of requirements or problems.
• Manage caregiver requests within required turnaround times, including conducting outreach to internal partners and 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.
• Use critical thinking to solve complex problems and identify when to escalate to the appropriate department.
• Perform call center functions, including handling inbound calls and supporting projects as directed by management.
• Maintain broad knowledge of client requirements, procedures, and key contacts.
• Support projects and other departments in completing tasks when directed by management.

Requirements & Tech Stack

• Bilingual in Korean/English.
• Flexible availability for alternate schedules/hours, including shifts between 11 AM and 9 PM EST, Monday through Friday, with training from 9 AM to 6 PM.
• 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).
• Previous multi-channel experience (voice, email, chat) is a plus.
• Some college or business school education is advantageous.

Qualifications

• Korean/English bilingualism.
• Experience in high-volume enrollment and eligibility transactions.
• Experience in 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.
• Basic computer skills, including Microsoft Office.
• Strong investigative and time management skills.
• Courteous and customer-service oriented.
• Detail-oriented and dependable.
• Effective communication through multiple channels.
• 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.