Eligibility Counselor

Change Healthcare Guaynabo , PR 00965

Posted 2 weeks ago

Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact.

As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.Here at Change Healthcare, we're using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life.

If you're ready to embrace your passion and do what you love with a company that's committed to supporting your future, then you belong at Change Healthcare.

Pursue purpose. Champion innovation. Earn trust. Be agile. Include all.

Empower Your Future. Make a Difference.

This position services to assist low-income Medicare be beneficiaries enrolled in a contracted Managed Care Organization Medicare+Choice health plan, with the qualification and recertification process for Medicare Savings Programs. The recertification team conducts telephonic outreach to remind, assist, and keep the members enrolled by either phone outreach or mailings. This outreach is performed before and around the members' recertification date.

Responsibilities:

  • Conducts telephonic outreach activities for members who need to recertify and are eligible for the Medicare Savings Programs. May also need to contact the state to properly complete the recertification process and to verify case status.

  • Completes MSP renewal applications if needed, for members. This would occur in the case that the member is unable to do so, and sends it to My Advocate for completion. Also, insure that applications are completely filled out and every questions is answered correctly before sending it back to member for signature.

  • Offer Community Link services to find additional programs that may assist members with their needs and interests. Must also conduct follow-up for incomplete application/documents for certain programs.

  • Conduct telephonic outreach to AL and MI members when their renewal application is received by the Government Relations department. Inform members the application will be sent to their physical address via mail (overnight). Must also provide instructions on how to complete the process.

  • Contact members when "Will-Stop" Notices have been received in order to avoid interruption of member's benefits. Instruct member to contact state to complete renewal process before the end date.

  • Must conduct proper and effective follow-up to ensure state renewal applications are sent to the state in a timely manner and Altegra Health documents are received to conduct further assistance.

  • Meet daily, weekly, and monthly production goals. Must also meet quality standards by ensuring proper phone etiquette and adherence to scripts, make accurate and descriptive MMS documentation.

  • Participates as required in Altegra Health's staff and operational development programs. Acts as a team player and communicates openly and honestly.

  • Maintains current knowledge of state and federal regulatory requirements to adhere to strict compliance of all aspects Altegra Health's Outreach Operations.

  • Demonstrates behaviors, actions, and attitudes that reflect Altegra Health's vision, mission and values.

  • Performs other duties as assigned.

Qualifications:

  • High School Education; Associates Degree preferred.

  • 2 years' experience with direct consumer interaction, telephone sales experience, Medicaid program experience preferred.

  • Demonstrated application of data entry and related computer skills.

  • Excellent oral communication skills; ability to communicate with elderly individuals and state governmental personnel.

Ability to analyze and interpret governmental program criteria; ability to interact and decipher information via telephonic or correspondence inquires.

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

Equal Opportunity/Affirmative Action Commitment

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or veteran status.


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Eligibility Counselor

Change Healthcare