Bilingual Care Operations Specialist

CareSource Management Services; New York (NY); On-site; USD 41,000 - 66,000; Full time

Job summary

CareSource Management Services is seeking an Operations Specialist - ESH to support care management and member services. The role involves clerical duties, coordinating services, processing authorizations, and assisting Nurse Care Managers to ensure timely care delivery.

The position requires high school or GED, bilingual ability in Spanish, Russian or Chinese, and familiarity with Medicaid/Medicare. Prior medical billing or terminology experience is preferred and a strong emphasis on HIPAA

Qualifications

• High School or GED required.
• Bilingual 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 in multiple languages as determined by needs of business is required.

Responsibilities

• Supports the provision of care plans, including ordering services for members (equipment and supplies, transportation, personal care, etc.), service intake from members, assisting Nurse Care Managers with member interactions, and authorizations processing.
• Answers incoming calls, makes outgoing calls as requested and/or review member care management survey results, identifying issues requiring follow up.
• Orders services and supplies, ensuring timely delivery.
• Provides back-up support to Member Services Representatives, including inbound and outbound call responsibility and other duties as needed to support Care Management and Member Services.
• Create a welcoming environment by acknowledging a patient's, visitor's and customer's presence immediately and being courteous and respectful to all.
• Convey a positive attitude by being friendly, kind and interested in helping others, giving full attention to what the customer is saying and listening without interruption.
• Acknowledge the customer's requests and concerns; Respond in a timely manner.
• Work closely with the Clinical Team.
• Ensure appropriate verification of documents.
• Ensure all applicable HIPAA and State requirements/regulations are adhered to at all times.
• Perform any other job related duties as requested.

Skills

Multilingual fluency

Customer service

Office software

HIPAA knowledge

Communication skills

Time management

Teamwork

Education

High School Diploma

Bilingual requirement

Healthcare familiarity

Tools

Microsoft Office

Medical billing terminology

Job description

CareSource Management Services is seeking an Operations Specialist - ESH to support care management and member services. The role involves clerical duties, coordinating services, processing authorizations, and assisting Nurse Care Managers to ensure timely care delivery.

The position requires high school or GED, bilingual ability in Spanish, Russian or Chinese, and familiarity with Medicaid/Medicare. Prior medical billing or terminology experience is preferred and a strong emphasis on HIPAA