Operations Specialist - Bronx

CareSource Management Services • New York City, NY

1d

About The Position

Job Summary: Responsible for the clerical, administrative, customer service and coordination activities to support care management and member services. Responsibilities may include ordering of services and supplies and assuring their timely delivery; member services representatives' duties, including inbound and outbound call responsibility and other duties as needed to support care management and member services. The Operations Specialist supports the provision of care plans. S/he may order services for members (equipment and supplies, transportation, personal care, etc.), take requests for services from members, assist Nurse Care Managers with member interactions, and take authorizations from Nurse Care Managers for processing. S/he will answer incoming calls, make outgoing calls as requested and/or review member care management survey results identified issues requiring follow up. Essential Functions: Acknowledge a patient’s, visitor’s and customer’s presence immediately. Smile and introduce yourself when appropriate. Create a home-like, healing environment by being courteous and respectful to all. Convey a positive attitude by being friendly, kind and interested in helping others. Always be willing to offer assistance to those in need. Give your full attention to what the customer is saying. Listen without interruption. Acknowledge the customer’s requests and concerns. Respond in a timely manner. Practice proper elevator etiquette Use proper telephone etiquette Wear identification badge correctly at all times. Contribute to effective teamwork in everything you do. Is responsible and cooperative with supervisors, fellow employees, residents, and visitors. Is open to suggestions and constructive criticism. Accepts constructive criticism as evidenced by appropriate changes in behavior. Maintains professional attitude. Maintains professional appearance. Handles conflicts as a professional. Utilizes established channels of communication. Recognizes limitations and seeks assistance appropriately. Promotes harmonious relationships and favorable attitudes among departments. Adheres to the Hebrew Home’s standards of e-mail etiquette. Perform any other job related duties as requested.

Requirements

• High School or GED required
• Bilingual (fluent in Spanish, Russian or Chinese) required
• Demonstrates knowledge of Medicare and Medicaid regulations.
• Demonstrates ability to utilize Microsoft Office Products.
• Demonstrates working knowledge of all federal, state, local and regulatory agency requirements as related to the department and position.
• Demonstrates the ability to integrate age specific requirements with individual developmental, mental, social and cultural needs when performing procedures for geriatric members.
• Excellent verbal and written communication skills
• Employment in this position is conditional pending successful clearance of a criminal background check. If the criminal background results are unacceptable, the offer will be withdrawn or, if employee has started in position, employment in position will be terminated.

Nice To Haves

• Some College/Business School preferred
• Familiarity with the healthcare environment (Medicaid/Medicare) preferred
• Previous Medical billing/terminology experience preferred
• Prior field experience working with therapists/other licensed medical professionals preferred

Responsibilities

• Responsible for the clerical, administrative, customer service and coordination activities to support care management and member services.
• Ordering of services and supplies and assuring their timely delivery
• Member services representatives' duties, including inbound and outbound call responsibility and other duties as needed to support care management and member services.
• Supports the provision of care plans.
• Order services for members (equipment and supplies, transportation, personal care, etc.)
• Take requests for services from members
• Assist Nurse Care Managers with member interactions
• Take authorizations from Nurse Care Managers for processing
• Answer incoming calls, make outgoing calls as requested and/or review member care management survey results identified issues requiring follow up.
• Perform any other job related duties as requested.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED