Bilingual NET Resource Specialist

AFMC; Little Rock (AR); Hybrid; USD 35,000 - 52,000; Full time

Job summary

AFMC is seeking a Full-Time position based in Little Rock, AR to support the Medicaid NET and EOTS helplines. You will resolve complex complaints, conduct research, and collaborate with medical staff to meet contract deliverables.

The role requires bilingual English/Spanish, a high school diploma (associate degree preferred), and health care experience. Strong communication, confidentiality, and multitasking are essential.

Qualifications

• Bilingual English/Spanish required.
• High School Diploma required; Associate's degree desirable.
• Two years of health care and complex complaint resolution experience.
• Medicaid and/or non-emergency transportation experience preferred.

Responsibilities

• Manage NET Helpline and EOTS Helpline operations.
• Resolve complaints through research, policy review, and solution development.
• Document activities and maintain accurate data for reporting.
• Maintain HIPAA compliance and data confidentiality.
• Collaborate with staff to meet contract deliverables and timelines.
• Monitor regulatory guidelines per the Transportation Broker agreement.

Skills

MS Office

Typing 50 wpm

Communication

Multitasking

Organizational skills

Problem-solving

Attention to detail

Teamwork

Education

High School Diploma

Bilingual English/Spanish

Associate's degree (desirable)

Job description

Job Title

Job Type

Full-Time

Category

Location

Work from Home LR Based - Little Rock, AR 72201 US (Primary)

Education

High School

Travel

Job Description

SCOPE OF POSITION:
Responsible for primary and/or secondary support of Arkansas Medicaid Non-Emergency Transportation (NET) Helpline and/or Extension of Transportation Services (EOTS) lines utilizing research and investigative approaches in order to achieve complex complaint resolutions and meet contract deliverables as assigned. Collaborate with medical and other professional staff to accomplish goals within designated timeframes. Support the initiative to improve and ensure continuous improvements in the quality of research and investigative methodology. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence, Accountability, Respect and Teamwork.

ESSENTIAL JOB FUNCTIONS:

• Maintain comprehensive knowledge of specialty area, pertinent organizations, health care environment, and organizations related to NET. Knowledge should include information regarding contract, contract deliverables, policies and procedures, resources available, current research, reports, and trends, as well as a thorough understanding of the NET Transportation Broker agreement with DMS/DHS.
• Responsible for the daily operation of the NET Helpline and the EOTS Helpline either as the primary or secondary accountable party.
• Responsible for the resolution of customer/beneficiary complaints/issues and requests including research, investigation, policy review, complex solution development, documentation and follow up in accordance with established policy and procedures.
• Maintain knowledge of various information systems such as state information systems and those associated with preauthorization of non-emergency transportation services.
• Communicate effectively with customers and/or beneficiaries. Develop and maintain collaborative relationships as necessary to meet contract deliverables of specialty area project.
• Understand and utilize project-tracking database to document and monitor activities provided and to compile a comprehensive database of activity. Maintain accurate statistical data to meet contractual and other reporting requirements.
• Understand and maintain knowledge regarding the use of any State data applications and policies used in accordance.
• Maintain knowledge of regulatory guidelines as stated in the transportation Broker agreement with the state and their application to contract deliverables.
• Track regulatory issues as stated in the Transportation Broker agreement with the state as they apply to beneficiary complaints and complaint resolution or the denial of services.
• Assist with validation of mandatory compliance documents received through the NET Portal.
• Coordinate the timely collection and data entry of all required documentation ensuring all internal Quality Assurance and HIPAA guidelines are followed.
• Monitor specific items within the area of focus, provide recommendations/ feedback to external customers for quality improvement and follow through for compliance of recommendations for improvement.
• Maintain knowledge in all other areas of Outreach Services teams to assist as needed with the overall operation of the Outreach Services department.
• Communicate needs and requests to other team members as appropriate.
• Ensure compliance with AFMC policy, contractual obligations, state and federal laws, regulations, and compliance documentation.
• Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance in conjunction with AFMC's internal quality measures.
• Daily quotas may be added to meet contract deliverables as needed.
• Additional duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Intermediate skill level with MS Office (Excel, Word, PowerPoint, and Outlook).
• Type 50 wpm.
• Strong skills in business English and spelling.
• Ability to maintain confidentiality.
• Strong oral and written communication skills.
• Creativity and flexibility.
• Ability to meet deadlines.
• Medical terminology.
• Ability to work collaboratively and independently to achieve stated goals.
• Initiative.
• Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public.
• Ability to multitask.
• Ability to prioritize.
• Strong organizational and problem-solving skills.
• Professionalism.
• Ability to read, interpret and apply laws, rules, and regulations.
• Regular and punctual attendance.
• Ability to work overtime as needed.

Job Requirements

Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress and ability to lift and transport 30 pounds. Must be capable of performing the essential functions of this job, with or without reasonable accommodations.

EDUCATION:
Required: Bilingual English/Spanish. High School Diploma
Desirable : Associate's degree or additional education

EXPERIENCE :
Required : Two (2) years of experience in health care community and research, and complex complaint resolution.
Desirable : Previous experience in Medicaid and/or non-emergency medical transportation.

INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)
An upload speed of at least 2Mbps is required to support softphone functionality.

Equal Opportunity Employer/Veterans/Disabled EEO IS THE LAW

AFMC, Inc. is an equal opportunity/affirmative action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability or any other status protected by federal, state and/or local law. AFMC invites any employee and/or applicant to review the Company's Affi... plan is available for inspection upon request, which may be made in person or by telephone [phone], by fax [phone] or by U.S. mail Attn: Human Resources, 1020 West 4th Street, Suite 400, Little Rock, AR 72201.