Remote Operations Specialist - Must reside in New York
Job Summary:
The Operations Specialist - ESH is responsible for the clerical, administrative, customer service and coordination activities to support Care Management and Member Services.
Essential Functions:Supports the provision of care plans, including ordering services for members (equipment and supplies, transportation, personal care, etc.), service intake from members, assisting Nurse Care Managers with member interactions, and authorizations processing.
Answers incoming calls, makes outgoing calls as requested and/or review member care management survey results, identifying issues requiring follow up.
Orders services and supplies, ensuring timely delivery.
Provides back-up support to Member Services Representatives, including inbound and outbound call responsibility and other duties as needed to support Care Management and Member Services.
Create a welcoming environment by acknowledging a patientās, visitorās and customerās presence immediately and being courteous and respectful to all.
Convey a positive attitude by being friendly, kind and interested in helping others, giving full attention to what the customer is saying and listening without interruption.
Acknowledge the customerās requests and concerns; Respond in a timely manner.
Work closely with the Clinical Team.
Ensure appropriate verification of documents.
Ensure all applicable HIPAA and State requirements/regulations are adhered to at all times.
Perform any other job related duties as requested.
Education and Experience:High School or GED required
Bilingual (fluent in Spanish, Russian or Chinese) required
Familiarity with the healthcare environment (Medicaid/Medicare) preferred
Previous Medical billing/terminology experience preferred
Prior field experience working with therapists/other licensed medical professionals preferred
Competencies, Knowledge and Skills:Fluency (speaking, reading, and writing) in multiple languages as determined by needs of business is required
Knowledge of Medicare and Medicaid regulations
Ability to utilize Microsoft Office Products
Knowledge of all federal, state, local and regulatory agency requirements as related to the department and position
Ability to integrate age specific requirements with individual developmental, mental, social and cultural needs when performing procedures for geriatric members
Excellent verbal and written communication skills
Ability to handle conflicts in a professional manner
Professional phone etiquette
Proper use of grammar
Ability to work in a fast paced environment
Adaptable to a constantly changing environment
Attention to detail
Ability to multitask
Ability to work independently and with a team
Critical thinking and listening skills
Decision making and problem solving skills
Licensure and Certification: None
Working Conditions:General office environment; may be required to sit or stand for extended periods of time
Travel is not typically required
Compensation Range:
$41,200.00 - $66,000.00CareSource takes into consideration a combination of a candidateās education, training, and experience as well as the positionās scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employeeās total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Hourly
Organization Level Competencies
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.
The Operations Specialist - ESH is responsible for the clerical, administrative, customer service and coordination activities to support Care Management and Member Services.
Essential Functions:Supports the provision of care plans, including ordering services for members (equipment and supplies, transportation, personal care, etc.), service intake from members, assisting Nurse Care Managers with member interactions, and authorizations processing.
Answers incoming calls, makes outgoing calls as requested and/or review member care management survey results, identifying issues requiring follow up.
Orders services and supplies, ensuring timely delivery.
Provides back-up support to Member Services Representatives, including inbound and outbound call responsibility and other duties as needed to support Care Management and Member Services.
Create a welcoming environment by acknowledging a patientās, visitorās and customerās presence immediately and being courteous and respectful to all.
Convey a positive attitude by being friendly, kind and interested in helping others, giving full attention to what the customer is saying and listening without interruption.
Acknowledge the customerās requests and concerns; Respond in a timely manner.
Work closely with the Clinical Team.
Ensure appropriate verification of documents.
Ensure all applicable HIPAA and State requirements/regulations are adhered to at all times.
Perform any other job related duties as requested.
Education and Experience:High School or GED required
Bilingual (fluent in Spanish, Russian or Chinese) required
Familiarity with the healthcare environment (Medicaid/Medicare) preferred
Previous Medical billing/terminology experience preferred
Prior field experience working with therapists/other licensed medical professionals preferred
Competencies, Knowledge and Skills:Fluency (speaking, reading, and writing) in multiple languages as determined by needs of business is required
Knowledge of Medicare and Medicaid regulations
Ability to utilize Microsoft Office Products
Knowledge of all federal, state, local and regulatory agency requirements as related to the department and position
Ability to integrate age specific requirements with individual developmental, mental, social and cultural needs when performing procedures for geriatric members
Excellent verbal and written communication skills
Ability to handle conflicts in a professional manner
Professional phone etiquette
Proper use of grammar
Ability to work in a fast paced environment
Adaptable to a constantly changing environment
Attention to detail
Ability to multitask
Ability to work independently and with a team
Critical thinking and listening skills
Decision making and problem solving skills
Licensure and Certification: None
Working Conditions:General office environment; may be required to sit or stand for extended periods of time
Travel is not typically required
Compensation Range:
$41,200.00 - $66,000.00CareSource takes into consideration a combination of a candidateās education, training, and experience as well as the positionās scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employeeās total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Hourly
Organization Level Competencies
Fostering a Collaborative Workplace Culture
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.