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.

$20.98 - $26.23 Hourly

What We Provide

What You Will Do

• 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.

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