Job Description

Location: Health Choice Management Co.
Posted Date: 11/12/2020

Position Purpose: Provide support to the Health Choice Member/Outreach Department by performing various clerical functions and maintained organized and effective procedures to support the department (including but not limited to):

  • Adhere to HIPAA laws at all times; notify Privacy Officer immediately upon learning of a real or potential breach of protected health information.
  • Process eligibility updated/ PCP changes / Open Panel Requests (MS, Providers, finance, IT, Network)
  • Work with IT to ensure eligibility is transmitting correctly to our vendors (Optum, MTBA, Clarity, etc.)
  • Interface with outside agencies to report or verify eligibility and update as necessary (UDOH, CMS, PMMIS, AHCCCS on line and Optum)
  • Prioritize work flow to maintain an efficient process of completing the assignments daily
  • Various error reporting (Pharmacy Report, Encounter Report, Daily Report, Finance Report, etc.)
  • Maintain Eligibility Mailbox (Processing incoming request, respond to inquiries from other departments, Materials Request, Claims History Request, etc.)
  • HIPAA / Discharges
  • Serve as back-up for Member Services Representative as necessary
  • Serve as back-up for Retention outbound projects as necessary

Education / Experience / Other Requirements

Education:

  • High School Diploma or equivalent GED preferred

Years of Experience:

  • At least one (1) year customer service preferred
  • At least one (1) year in call center environment preferred

Specialized Knowledge:

  • Microsoft Office (Word, Excel)
  • Proficient computer skills, typing, and multi-systems navigation
  • Excellent verbal and written communication skills
  • Active listening skills, highly empathetic, conflict resolution skills

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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