Centers Plan for Healthy Living

  • Benefits Eligibility Coordinator - Field

    Job Locations US-NY-Staten Island
    Posted Date 4 months ago(3/13/2018 1:36 PM)
    ID
    2018-1282
    # of Openings
    1
    Category
    Enrollment
  • Overview

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    JOB SUMMARY:

     

    The Benefits Eligibility Field Coordinator is responsible for verifying insurance benefits of MLTC members and obtaining outstanding documentation needed to validate the prospect’s or member’s eligibility. This entails; conducting home visits of prospective and enrolled members, fact checking application forms, assisting with the resolution of eligibility issues, and data collection.

    Excellent customer service skills and professional demeaner required.

    Responsibilities

    PRIMARY RESPONSIBILITIES:

    • Collects necessary documentation for program eligibility, including visiting the member at home.
    • Documents and records all efforts and steps taken.
    • Assists with troubleshooting eligibility issues through research and facilitating the resolution of the problem in a timely fashion.
    • Insures timely completion of all necessary paperwork.
    • Maintains clear and accurate documentation in CPHL Membership Database.
    • Communicates professionally and appropriately with prospective and enrolled members.
    • Ensures compliance to departmental and external standards.
    • Keeps confidential all prospective and enrolled members information.
    • Additional assignments and duties as needed.

    Qualifications

    Education and Experience:

     

    Education

     

    Required:

    •  High School Diploma

     

    Preferred:  

    • Bachelor’s Degree

     

    Type of Experience      

     

     Required: 

    • Minimum one-year customer service experience.
    • Strong attention to detail and the ability to provide efficient, quality service to both internal and external customers.
    • Solid interpersonal skills along with the ability and willingness to respect and value the differences and perceptions of different groups/individuals.

     

     

    Preferred:

    • Medical billing or medical business office experience with knowledge of Medicare, Medicaid Managed Care, and eligibility regulations.

    Certifications/Licensure:

    Required: 

    • Valid Driver’s License

     

     

    Knowledge and Skills

     

    Required:  

    • Basic knowledge of Microsoft Office and Outlook (Word & Excel)

     

    Preferred:

    • Knowledge of MLTC regulatory requirements
    • Knowledge of Medicaid Eligibility regulations

     

     

    SCOPE INFORMATION:

     

    Direct Reports: 0                                

               

     

    Physical Requirements:

     

    The physical requirements described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

     

    Ability to travel within service area (NYC, Rockland, Westchester, Suffolk, Nassau counties)

     

    The above statements are intended to describe the general nature and level of work performed by individuals assigned to the job classification.  They should not be construed as an exhaustive list of all responsibilities, duties and skills required.

     

     

     

     

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