Field Health Benefits Coordinator

About the role

Assists walk-in and telephone customers with completing new and renewal applications, HMO selection forms and answers questions about the program benefits, enrollment, and eligibility.

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.

Responsibilities

• Assists walk-in and telephone customers with completing new and renewal applications, HMO selection forms and answers questions about the program benefits, enrollment, and eligibility.
• 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.

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.

Qualifications

• 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.

Skills

• Knowledge of Medicaid and managed care programs.
• Solving problems through analysis and ongoing feedback.
• Working with people of diverse backgrounds.
• Handling multiple tasks and meeting deadlines.
• Maintaining strict confidentiality.
• Independent work capability.
• Verbal, written, and interpersonal skills.
• Bilingual capabilities.
• Interpreting and applying program policies and procedures.
• Using basic arithmetic procedures.

Benefits

• Full benefit options including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time.

Pay

$20.00 per hour pay rate (bi-weekly pay)

Schedule

Full-time schedule (40 hrs. a week)