Overview
Assesses eligibility of the Sales team's VNS Health Medicare referrals, processes and enter referrals into our referral management system(s), works as a VNS Health plan representative for NYMC to complete NYMC transfer calls, schedules internal nurse assessments and works with various departments to resolve any Medicaid-related issues. Works under general supervision.
Responsibilities
• Provides education to consumers on our Medicare plans’ eligibility requirements. • Reviews and confirms potential enrollees eligibility; collaborates with New York Medicaid Choice (NYMC) in scheduling NYIA’s (New York Independent Assessment), including follow up as needed to obtain NYIA scheduled dates and outcomes • Promotes satisfactory enrollee relationships and responds to inquiries regarding eligibility and program related information. • Works with our internal and external customers to ensure referrals are processed and followed up on as needed. Collaborates with clients to resolve pre-enrollment issues. • Assigns referrals to VNS Health Sales agents in Salesforce for Medicare application/SOA follow-up • Provides outreach to potential enrollees who are referred via various referral methods. Reviews their eligibility and transfers them to NYMC, if appropriate. Offers Medicaid assistance, as needed. • Works closely with VNS Health’s Enrollment department to process daily submissions received internally for enrollment to NYMC and follows up appropriately when needed. • Collaborates internally to ensure consumers are enrolled effectively and required documents are loaded into the member record system. • Serves as a liaison between Sales, Clinical teams and other departments. • Receives and responds to inbound calls to ensure the consumer's needs are understood and addressed to create a positive customer experience. • Establishes effective customer-focused working relationships with members, physicians and providers of long term care services. • Participates in special projects and performs other duties as assigned.
Qualifications
Education:
Associate's Degree in health, human services, other related discipline or the equivalent work experience required
Work Experience:
Minimum two years experience in customer service or business operations required Minimum one year experience working in a Call Center setting required Proficient interpersonal, organizational, strong attention to detail, analytical and writing skills required Knowledge of Medicaid eligibility requirements required Strong understanding or experience with Salesforce preferred Proficiency with personal computers, including MS Excel, Word and Outlook required preferred