Location: Bronx, NY
Name: Michelle Irizarry
PURPOSE OF THE POSITION
Assure thorough, prompt determination (and re-determination, as appropriate) of applicant eligibility for all program enrollment, consistent with statutory criteria, and contractual, regulatory and corporate policies and procedures.
- Evaluate, process, and route new and Recertification enrollment applications under established regulatory and management guidelines with acceptable levels of quality and quantity to assure superior customer service.
- Process HRA/LDSS inquiries.
- Meet or exceed quality and productivity expectations.
- Identify and immediately report any issues that pose a risk a risk to superior service or potential for liability to department management.
- Work cooperatively with staff throughout the company, and contribute to the overall success of Marketing and Membership.
- Perform other duties as necessary or required.
- High School diploma, Associates degree preferred, or equivalent business experience.
- One year health care enrollment experience, preferably in a managed care/health care environment with demonstrated success in achieving quality and productivity goals.
- Basic level proficiency with computer software applications and office technology.
- Special interpersonal skills, including tact and diplomacy, demonstrated by the ability to constructively interface with peers, management and internal and external customers.
- Strong written and verbal communication skills as demonstrated by the ability to understand detailed policies, procedures, plan provisions and practices, relate them to the work assignment and communicate information/responses/solutions clearly and understandably to staff and management.
- Bilingual preferred.
- Resourcefulness required in developing improved methods, procedures or techniques relating to own activities. Requires resourcefulness in applying technical knowledge to new situations/questions/issues.
- Strong analytical skills, detail orientation and the ability to understand and adhere to established policies and procedures.
- High level of integrity as demonstrated by 1) appropriate treatment of confidential information, 2) adherence to policies, procedures, rules and regulations and 3) professional conduct in dealing with persons internal and external to the organization and 4) sensitivity towards the target population is essential.