Multilingual Care Operations & Member Support Specialist

CareSource; New York (NY); On-site; USD 57,000 - 91,000; Full time

Job summary

CareSource seeks an Operations Specialist - ESH to support Care Management and Member Services through clerical, administrative and customer service tasks. The role coordinates care plan services, processes authorizations, and ensures HIPAA compliance.

The candidate will handle member calls, assist nurses, and work closely with the Clinical Team to verify documents. Requirements include a High School diploma or GED, bilingual ability (Spanish, Russian or Chinese), and familiarity with

Qualifications

• High School or GED required.
• Bilingual (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.

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

Bilingual multilingual

Fluent in multiple languages

Microsoft Office

Medicare/Medicaid knowledge

Attention to detail

Verbal and written communication

Multitasking

Teamwork

Phone etiquette

Education

High School diploma or GED

Tools

Microsoft Office

Job description

CareSource seeks an Operations Specialist - ESH to support Care Management and Member Services through clerical, administrative and customer service tasks. The role coordinates care plan services, processes authorizations, and ensures HIPAA compliance.

The candidate will handle member calls, assist nurses, and work closely with the Clinical Team to verify documents. Requirements include a High School diploma or GED, bilingual ability (Spanish, Russian or Chinese), and familiarity with