JOB PURPOSE: The purpose of this department is to ensure all incoming and outgoing phone calls are conducted professionally, timely, and accurately while following Federal and State regulations. This department will be the central source for inquiries and will be the main contact for external parties for Comprehensive Care Management organization and our PACE, Managed Long Term Care, and Medicare Advantage products.
Education: High School Diploma with evidence of continuing education and/or a Bachelor’s degree, preferably in health or business administration.
Experience: Have at least 1-2 years recent experience in the healthcare industry. Minimum 1-2 years member services / customer service experience.
Other: Must be knowledgeable in Medicare and Medicaid, plan terms and CMS regulations. Must have the ability to handle multiple tasks and complete work under tight deadlines. Must be motivated and confident, must have drive & energy, and must be service and results-oriented. Excellent oral communication skills. Strong interpersonal skills and ability to interact with people. Proficiency with MS Office suite (Word, Excel, Outlook). Detail-oriented; highly organized; excellent organizational skills. Ability to take initiative and to follow through on issues. Operational knowledge of health insurance business, particularly related to enrollment, claims, or member services.
Must be bilingual (English/Russian).