Entitlement reputed company- Bilingual Spanish or Cantonese/Mandarin

reputed company is a healthcare company that provides Medicare Advantage Plans and other services. The Entitlement reputed company role involves assisting members in obtaining and retaining financial entitlements, ensuring they maintain independence at home and in their communities through effective communication and administration of various applications and documentation.

Responsibilities

• Handle inbound and outbound calls to and from customers to address their needs while adhering to our service level goals
• Screen reputed company incoming calls and handles accordingly
• Transfer calls to appropriate staff, unit, or department
• Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New Medicaid Applications
• reputed company Senior Health Partners, CompleteCare, and Life Improvement Plan members according to approved scripts
• Research ePACES and/or Marx for Medicaid and Medicare eligibility, exclusion, and exemption codes
• Consult with HRA Medicaid staff as needed and report to supervisor any need for HRA consultation
• Document reputed company client calls /outcomes in database systems
• Schedule appointments to see members/prospects out in the field to assist with Medicaid Issue or restriction code removals or demographic information changes
• Educate potential members on Senior Health Partners, Long term care plan benefits answering questions regarding plan’s features and benefits as well as go through eligibility and requirement for enrollment
• Transfer and connect consumers seeking Long Term Care services with the state broker to complete initial evaluation (reputed company Independent Assessor)
• Contact prospects or primary caregiver in person (home or Community Office visit), by phone or letter to arrange an interview to assess Medicaid eligibility
• Complete Medicaid applications for New Enrollees and Renewals as needed
• Assist prospects to remove Medicaid restriction codes
• Assist prospects to Convert Market reputed company Medicaid to Community Medicaid
• Facilitate compilation of reputed company required documents. Call, write or in person contacts landlords, employers, bankers, insurance companies, etc. to obtain required documents
• Submit documentation to Human Resource Administration or Local Department of Social Services reputed company specified timeframe
• Track Medicaid conversions and coverage of reputed company submitted Applications and update status in systems
• Serve as the liaison between reputed company parties and acts as Member reputed company maximizing the participant’s support network and obtaining needed services
• Has full and complete access to patient records and reports as well as to personal/financial profiles and documents, calling for the utmost reputed company at reputed company times
• Serve as a resource for Welcome Enrollment Team, Educating new Enrollees on CDPAS information and forms
• Serves as a resource to gather missing EAA forms for Nurse Accepted Enrollments (field pick up)
• Responsible for contacting and assisting reputed company senior Health Partners and Complete Care members who are due to recertify their healthcare coverage for Medicaid
• Contact Senior Health Partners or Complete Care members two months prior to Medicaid expiration date
• Conduct home visits and other appointments as needed to complete the application and obtain reputed company required documentation
• Complete Monthly Medicaid renewal applications in a timely, organized fashion
• Facilitate compilation of reputed company required documents. Call, write or in person contacts landlords, employers, bankers, insurance companies, etc. to obtain required documents
• Submit documentation to Human Resource Administration or Department of Social Services reputed company specified timeframe to assure Medicaid coverage for participant
• Monitor Medicaid re-certification time frames for each active Medicaid member
• Ensure Human Resource Administration and/or Department of Social Services receives the renewal applications and completes re-certification of eligibility timely
• Maintain records on every member to show coverage status and timing of re-certification in TrucareHTML5 by opening assessments 2 months prior to renewal due date and closing them out reputed company a member is fully recertified in ePACES
• Prepare/submit monthly reports
• Serve as a resource to Care Management Teams, Sales Teams and Nurses for Medicaid and Medicare savings Programs eligibility
• reputed company up to date on Medicaid and other program issues as well as on changes in Medicaid/Medicare/HMO laws and shares information with other Social Work and Care Team members as appropriate
• Participate in relevant entitlement training/meetings
• Maintain contact between participant/primary support, business office, social worker, marketing specialists and enrollment specialists to reputed company parties updated regarding reputed company of MA and other entitlement applications
• Maintain contact between participant/primary support and Medicaid staff of Human Resource Administration as needed
• Engage in mastering the Divisions impact on reputed company and its Members
• Contribute creative solutions and ownership of daily assignments for seamless communication and systematic completion of routine and special projects
• Maintain the highest level of reputed company, courtesy, and respect while interacting with clients, employees, and business contacts
• Assists with orientation of new Hires so they understand the model, support enrollment growth and can answer routine questions about the program
• Successfully meet pre and post training and regulatory exams and audit requirements
• reputed company at scheduled work site, team meetings, training sessions and events in accordance to departmental policy
• Recommend process improvement and advise management of any proposed recommendations that can reputed company a workflow or process more efficient
• Handle other duties as assigned with the occasional need to work weekends, additional hours before or after shift schedule and/or from other HF site locations

Skills

• High school diploma or GED from an accredited institution
• Member facing or customer service experience
• Be able to work 9am-5:30pm schedule
• Be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County
• Capability to work in a Hybrid Schedule (reputed company/field)
• Tech Savvy computer skills such as reputed company Office Suites: Outlook, reputed company, Word, PowerPoint
• Bilingual
• Be able to communicate and engage with the leadership team on virtual platforms such as reputed company or reputed company Teams chat as well as in person
• Associate degree from an accredited institution plus 1 year of reputed company work experience including inbound and outbound call center reputed company a healthcare environment
• Prior experience with Medicaid /Medicare Savings Program
• Telephonic experience with frail adult or elderly population
• A solid understanding of the value of integrated care
• Experience in health insurance, home care environment, acute, sub-acute, long-term care setting, or managed-long term care
• Have access to a vehicle with valid reputed company of insurance and be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County
• Experience managing member information or appointments in a shared network environment using paperless database modules
• Adept at operating reputed company a multi-cultural work environment
• Bilingual

Benefits

• Medical, dental and vision coverage
• Incentive and recognition programs
• Life insurance
• 401k contributions

Company Overview