Medicaid Services Advocate (PA.OH)

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Job description

Qualifications:

Prefer 1-year prior experience in an office setting, call center setting or phone support role, but not required

An education level of at least a high school diploma or GED

Demonstrated ability to quickly build rapport and respond to customers in a compassionate manner by identifying and exceeding customer expectations (responding in respectful, timely manner, consistently meeting commitments)

Demonstrated ability to listen skillfully, collect relevant information, determine immediate requests and identify the current and future needs of the member

Proficient problem-solving approach to quickly assess current state and formulate recommendations

Proficient in translating healthcare-related jargon and complex processes into simple, step-by-step instructions customers can understand and act upon

Flexibility to customize approach to meet all types of member communication styles and personalities

Proficient conflict management skills to include ability to resolve issues in a stressful situation and demonstrating personal resilience

Ability to work regularly scheduled shifts within our hours of operation including the training period, where lunches and breaks are scheduled, with the flexibility to adjust daily schedule, and work over-time and/or weekends, as needed

All new hires will be required to successfully complete the Customer Service training classes and demonstrate proficiency of the material

Job Responsibility:

Respond to and resolve on the first call, customer service inquires and issues by identifying the topic and type of assistance the caller needs such as benefits, eligibility and claims, financial spending accounts and correspondence.

Help guide and educate customers about the fundamentals and benefits of consumer-driven health care topics to include managing their health and well-being by selecting the best benefit plan options, maximizing the value of their health plan benefits and choosing a quality care provider

Intervene with care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed

Assist customers in navigating websites and encourage and reassure them to become self-sufficient

Own problem through to resolution on behalf of the customer in real time or through comprehensive and timely follow-up with the member

Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues

Provide education and status on previously submitted pre-authorizations or pre-determination requests

Meet the performance goals established for the position in the areas of efficiency, call quality, customer satisfaction, first call resolution and attendance

Hiring and Interview Process:

1.Resume, Assessment scores and Internet Speeds submitted to hiring team for review

2.Initial Phone Screen after review by hiring team

3.Additional Assessment issued upon request from Hiring team

4.Virtual (MS Teams Meeting) Interview scheduled

Screening Requirements:

7-year Criminal Background Screening (3 year no exception policy)

10 Panel Drug Screen (Includes Marijuana screening and a Medical Card does not apply. The client follows Federal Restrictions

• Only those lawfully authorized to work in the designated country associated with the position will be considered.

• Please note that all Position start dates and duration are estimates and may be reduced or lengthened based upon a client's business needs and requirements.

Benefits:

For information and details on employment benefits offered with this position, please visit here . Should you have any questions/concerns, please contact our HR Department via our secure website .

California Pay Equity:

For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here .

Rose International is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender (expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law. Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.

If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department .

Rose International has an official agreement (ID ), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).

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