Member Service Support Unit Representative - New York, United States - VIllageCare of New York

VIllageCare of New York

Verified Company

New York, United States

3 weeks ago

Posted by:

Mark Lane

beBee recruiter

Description

Member Service Unit Representative
VillageCareMAX

112 Charles Street, New York, NY 10014

COME WORK FOR THE LEADING, LOCAL MANAGED CARE COMPANY - VILLAGE CARE

Essential Job Functions:

Facilitates communication between members, subcontractors, providers and Care Managers
Handles member, vendor and provider requests for information and member materials
Responsible for administrative duties including processing faxes, scanning and mailing
Maintains and updates member records with pertinent information as necessary
Provides plan information to new members, family members or other representatives as requested
Assists members with accessing translation services
Participates in special projects in response to program needs
Backs up the Member Services queue as required by operations, answering inbound calls and routing to the appropriate responsible parties
Resolves same day grievance complaints where possible
Other duties as assigned

Role Competencies:

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Industry Understanding - Knowing the key concepts and variables of healthcare provider services and payment (including Medicaid and Medicare).
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Planning & Organizing

Identifying goals, objectives, methods, resources needed to carry out methods, responsibilities and dates for completion of tasks.

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Problem Analysis

Ability to detect problems, recognize important information, and link various data; to trace potential causes and look for relevant details.

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Evaluating with Tact:

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Coordinating and Controlling Resources - Monitoring and adjusting resources and processes to achieve goals and objectives in a highly effective and efficient fashion.
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Integrity & Commitment - Reliable and, in word and deeds, upholds VillageCare code of conduct and compliance. Accounts for actions with valid arguments, properly directs own activities, and can self-correct.
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Communication Skills - Stimulates effective communication between individuals and groups that attempt to solve differences of opinion and conflicts. Able to communicate effectively in writing and orally, actively and passively, person to person and in a group. Can effectively interact with senior management team, providers, and federal and state regulators.

Qualifications & Minimum Requirements:

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Education: Associates Degree

Experience:
A minimum of 3 years of job-related experience. Experience in MLTC environment or Health Care a plus**
Physical Requirements & Working Conditions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions._
Must have use of sensory skills in order to effectively communicate and interact with other employees and the public through the use of the telephone and personal contact as normally defined by the ability to see, read, talk, hear, handle or feel objects and controls.
Manual dexterity necessary to efficiently operate office equipment. Minimal bending, carrying, kneeling, crawling, reaching, pushing, and pulling. Ability to lift up to 10 lbs.
May be required to stand and/or remain in a stationary position for long periods of time.