Eligibility Counselor I

Altegra Health; Town of Florida (NY); On-site; USD 35,000 - 50,000; Full time

Job summary

A healthcare services provider is seeking an Outreach Specialist to assist low-income Medicare beneficiaries with the qualification and recertification process for Medicare Savings Programs. The role involves conducting telephonic outreach, completing renewal applications, and ensuring compliance with regulatory requirements. Ideal candidates will have strong communication skills, preferably be bilingual in English and Spanish, and possess relevant experience in consumer interaction and Medicaid programs. This position is moving to Weston, FL soon.

Qualifications

• Experience with direct consumer interaction and telephone sales.
• Medicaid program experience preferred.
• Ability to analyze governmental program criteria.

Responsibilities

• Conduct telephonic outreach for members needing recertification.
• Complete MSP renewal applications to assist members.
• Ensure timely submission of state renewal applications.

Skills

Bilingual English and Spanish

Excellent oral communication skills

Data entry skills

Education

High School Education; Associates or Bachelor's Degree preferred

Job description

Over 20 million individuals benefit from services that Altegra Health provides. When you join our team, you stand on the foundation of a successful organization that enriches an individual's life. We place a high value on qualities such as integrity, empathy, excellence and trust.

Job Description

This position services to assist low-income Medicare beneficiaries enrolled in a contracted Managed Care Organization Medicare+Choice health plan, with the qualification and recertification process for Medicare Savings Programs. The recertification team conducts telephonic outreach to remind, assist, and keep the members enrolled by either phone outreach and mailings. This outreach is performed before and around the members’ recertification date.

Responsibilities

• Conduct telephonic outreach activities for members who need to recertify and are eligible for the Medicare Savings Programs. May also need to contact the state to properly complete the recertification process.
• Complete MSP renewal applications if needed for members. Also, insure that applications are completely filled out and every question is answered correctly before the member submits it to the state.
• Must conduct proper and effective follow up to ensure state renewal applications are sent to the state in a timely manner and Altegra Health documents are received to conduct further assistance.
• Meet daily, weekly, and monthly production goals. Must also meet quality standards by ensuring proper phone etiquette and adherence to scripts, make accurate and descriptive MMS documentation.
• Participate as required in Altegra Health's staff and operational development programs. Acts as a team player and communicates openly and honestly.
• Maintain current knowledge of state and federal regulatory requirements to adhere to strict compliance of all aspects Altegra Health's Outreach Operations.
• Demonstrate behaviors, actions, and attitudes that reflect Altegra Health's vision, mission and values.
• Perform other duties as assigned.

Qualifications

• High School Education; Associates Degree or Bachelors Degree preferred.
• 2 years experience with direct consumer interaction, telephone sales experience, Medicaid program experience preferred.
• Demonstrated application of data entry and related computer skills.
• Excellent oral communication skills; ability to communicate with elderly individuals and state governmental personnel.
• Ability to analyze and interpret governmental program criteria; ability to interact and decipher information via telephonic or correspondence inquires.

**MUST BE BILINGUAL ENGLISH AND SPANISH

Additional Information

We are located in Miami Lakes, FL now but in November we are moving to Weston, FL.