Field Health Benefits Coordinator

Conduent State Healthcare, LLC•Westmont, NJ

53d•Hybrid

About The Position

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day. Position Purpose: Reports to the Outreach Supervisor and serves as a key liaison between the NJ FamilyCare program and the community. Delivers presentations to groups and individuals, providing clear and courteous information about program benefits, enrollment, and eligibility. Assists beneficiaries with application completion and eligibility determination.

Requirements

Associate degree from an accredited college or university.
Two (2) minimum experience in the healthcare field.
Knowledge and operational experience in Medicaid and/or CHIP programs are a plus.
General knowledge of public health, managed care, human services systems, and local and statewide political systems preferred.
Experience working with people representing diverse backgrounds is preferred.
Knowledge of Medicaid and managed care programs.
Ability to solve problems through analysis and ongoing feedback.
Ability to work with people of diverse backgrounds.
Ability to handle multiple tasks and meet deadlines, flexibility under pressure.
Ability to maintain strict confidentiality.
Capable of working independently.
Excellent verbal, written, and interpersonal skills.
Bilingual capabilities a plus.
Ability to interpret and apply program policies and procedures as appropriate.
Ability to use basic arithmetic procedures to determine the household size and income, and program eligibility.
Ability to apply logical reasoning to make timely, effective decisions.

Responsibilities

Assists walk-in and telephone customers with completing new and renewal applications, HMO selection forms and answers questions about the program.
Conducts presentations to educate consumers about NJFC and the benefits of managed care within an office and call center setting, at Community Based Organizations, community events and home visits with some evening and some weekend events.
Respond to telephone inquiries and complaints in a call center environment using standard scripts and procedures.
Enters eligibility information into a web-based computer system and references other NJ-specific databases as appropriate.
Determine eligibility for NJ FamilyCare according to the NJ FamilyCare regulations/guidelines by reviewing documentation and following procedures; prepare correspondence for missing information as appropriate; make outbound calls to obtain, clarify, or validate information.
Participate in and contribute to the quality improvement process.
Participate in training sessions conducted in Hamilton and at the regional offices.
Other duties as assigned.