Bilingual NET Resource Specialist

AFMC•Little Rock, AR

13d•Remote

About The Position

Responsible for primary and/or secondary support of Arkansas Medicaid Non-Emergency Transportation (NET) Helpline and/or Extension of Transportation Services (EOTS) lines utilizing research and investigative approaches in order to achieve complex complaint resolutions and meet contract deliverables as assigned. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Support the initiative to improve and ensure continuous improvements in the quality of research and investigative methodology. Support the organization’s mission, vision, and values by exhibiting honesty, excellence, accountability, respect, and teamwork.

Requirements

Bilingual English/Spanish.
High School Diploma.
Two (2) years of experience in health care community and research, and complex complaint resolution.
Intermediate skill level with MS Office (Excel, Word, PowerPoint, and Outlook).
Type 50 wpm.
Strong skills in business English and spelling.
Ability to maintain confidentiality.
Strong oral and written communication skills.
Creativity and flexibility.
Ability to meet deadlines.
Attention to detail.
Medical terminology.
Ability to work collaboratively and independently to achieve stated goals.
Initiative.
Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public.
Ability to multitask.
Ability to prioritize.
Strong organizational and problem-solving skills.
Professionalism.
Ability to read, interpret and apply laws, rules, and regulations.
Time management skills.
Regular and punctual attendance.
Ability to work overtime as needed.
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to lift and transport 30 pounds.
Must be capable of performing the essential functions of this job, with or without reasonable accommodations.
Reliable, high-speed wireless internet service (Wi-Fi) with an upload speed of at least 2Mbps.

Nice To Haves

Associate’s degree or additional education.
Previous experience in Medicaid and/or non-emergency medical transportation.

Responsibilities

Maintain comprehensive knowledge of specialty area, pertinent organizations, health care environment, and organizations related to NET, including contract details, deliverables, policies, procedures, available resources, current research, reports, trends, and a thorough understanding of the NET Transportation Broker agreement with DMS/DHS.
Responsible for the daily operation of the NET Helpline and the EOTS Helpline, either as the primary or secondary accountable party.
Responsible for the resolution of customer/beneficiary complaints/issues and requests, including research, investigation, policy review, complex solution development, documentation, and follow-up in accordance with established policy and procedures.
Maintain knowledge of various information systems, such as state information systems and those associated with preauthorization of non-emergency transportation services.
Communicate effectively with customers and/or beneficiaries.
Develop and maintain collaborative relationships as necessary to meet contract deliverables of the specialty area project.
Understand and utilize the project-tracking database to document and monitor activities and compile a comprehensive database of activity.
Maintain accurate statistical data to meet contractual and other reporting requirements.
Understand and maintain knowledge regarding the use of any State data applications and policies used in accordance.
Maintain knowledge of regulatory guidelines as stated in the transportation Broker agreement with the state and their application to contract deliverables.
Track regulatory issues as stated in the Transportation Broker agreement with the state as they apply to beneficiary complaints and complaint resolution or the denial of services.
Assist with validation of mandatory compliance documents received through the NET Portal.
Coordinate the timely collection and data entry of all required documentation, ensuring all internal Quality Assurance and HIPAA guidelines are followed.
Monitor specific items within the area of focus, provide recommendations/feedback to external customers for quality improvement, and follow through for compliance of recommendations for improvement.
Maintain knowledge in all other areas of Outreach Services teams to assist as needed with the overall operation of the Outreach Services department.
Communicate needs and requests to other team members as appropriate.
Ensure compliance with AFMC policy, contractual obligations, state and federal laws, regulations, and compliance documentation.
Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance in conjunction with AFMC’s internal quality measures.
Daily quotas may be added to meet contract deliverables as needed.
Additional duties as assigned.