Assesses eligibility and initiates the referral process for VNS Health Plan Services, by entering the referrals in the Pre-Enrollment Browser (PEB), to achieve desired enrollment goals. Works under general supervision.
Responsibilities
Assesses eligibility of potential enrollees; collaborates with New York Medicaid Choice (NYMC) in scheduling Conflict-Free Evaluation and Enrollment Center (CFEEC) assessments, as needed.Promotes satisfactory enrollee relationships and responds to inquiries about eligibility and requests for program information. Follows up with clients about CFEEC assessment status and collaborates with clients to resolve pre-enrollment problems.Calls potential enrollees who are referred via fax; reviews their eligibility and transfers them to NYMC, if appropriate.Compiles data/information, enters into systems/databases or other programs (e.g. referrals) using appropriate software/systems. Maintains accurate data in all applicable systems to ensure timely withdrawals/cancellations, enrollments and accurate claims adjudication. Documents and tracks calls in appropriate systems. Addresses issues and/or forwards them to appropriate area for resolution.Works collaboratively with other VNSNY programs as needed.Confirms attestation date in UAS for enrolled Members.Conducts pre-enrollment welcome calls to newly enrolled members advising them of their assigned LHCSA and potential HHA hours.Participates in special projects and performs other related duties as assigned.
Qualifications
Education:Associate’s Degree in health, human services, other related discipline or the equivalent work experience required.
Experience: Minimum two years experience in customer service required. Proficient interpersonal, organizational, strong attention to detail, analytical and writing skills required. Knowledge of Medicaid eligibility requirements required. Proficiency with personal computers, including MS Excel, Word and Outlook required. Prior experience in Call Center setting preferred. Cantonese/Mandarin Bi-lingual required.