Operations Specialist - Must reside in New York - R12893

Job Summary

The Operations Specialist - ESH is responsible for supporting the provision of care plans, managing member services, and coordinating administrative tasks.

Essential Functions

• Supports the provision of care plans, including ordering services for members and assisting with member interactions.
• Answers and makes calls, reviews member care management survey results, and identifies issues requiring follow up.
• Orders services and supplies, ensuring timely delivery.
• Provides back-up support to Member Services Representatives, handling inbound and outbound calls and other duties as needed.
• Creates a welcoming environment by acknowledging and responding promptly to customer requests and concerns.
• Works closely with the Clinical Team and ensures appropriate verification of documents.
• Ensures compliance with HIPAA and state requirements.
• Performs other job-related duties as requested.

Education and Experience

• High School or GED required
• Bilingual (fluent in Spanish, Russian or Chinese) required
• 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
• Fluency (speaking, reading, and writing) in multiple languages as determined by needs of business is required
• Knowledge of Medicare and Medicaid regulations
• Ability to utilize Microsoft Office Products
• Knowledge of all federal, state, local and regulatory agency requirements as related to the department and position
• 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
• Ability to handle conflicts in a professional manner
• Professional phone etiquette
• Proper use of grammar
• Ability to work in a fast-paced environment
• Adaptable to a constantly changing environment
• Attention to detail
• Ability to multitask
• Ability to work independently and with a team
• Critical thinking and listening skills
• Decision-making and problem-solving skills

Compensation Range

$41,200.00 - $66,000.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type

Hourly

Competencies

• Fostering a Collaborative Workplace Culture
• Cultivate Partnerships
• Develop Self and Others
• Drive Execution
• Influence Others
• Pursue Personal Excellence
• Understand the Business