Req #: 1773

Job ID: 13321

Job Location: New York, NY

Zip Code: 10040

Category: Office and Administrative Support

Agency: Elderplan

Status: Regular Full-Time

Office: Office-based

Salary: $46,640.15 - $58,300.19 per year

The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.

Why work for MJHS?:

When you work with us you will receive comprehensive and affordable health and financial benefits, in addition to generous paid vacation, personal and holiday time that you won't find at our competitors. Do you receive a paid day off for your birthday now? No? You will here! You will also receive the training, tuition assistance and career development you desire to help you achieve your career goals. You take care of our patients, residents and health plan members, and we will take care of the rest!

Benefits include:

* Tuition Reimbursement for all full and part-time staff

* Generous paid time off

* Affordable medical, dental and vision coverage for employee and family members

* Two retirement plans! 403(b) AND Employer Paid Pension

* Flexible spending

* And MORE!

MJHS companies are qualified employers under the Federal Government's Paid Student Loan Forgiveness Program (PSLF)

Responsibilities:

Coordinates all Medicaid and Social Service Program benefits for plan members. Assures program eligibility criteria are met; required documentation is collected, reviewed, assessed, and submitted. Eligibility determinations, fair hearing and grievance options are explained to the member/designated representative. Monitors application recertification to ensure timely processing, and resolves all financial billing discrepancies to ensure the reduction of the capitation receivable. Assists members by coordinating Medicaid and Social Service-related benefits for active HomeFirst, FIDA and MAP members. Updates Market Prominence, Payor and other systems with member's documentation and changes. Provides answers to inquiries and follow-up information to the Member Services Department.

Qualifications:

* High School diploma or equivalent, required; Bachelor's Degree, preferred

* 2-3 years prior experience in Managed Long Term Care(MLTCP) and Medicaid, preferred

* Bilingual preferred, verbal and written communication

* Working knowledge of various computer programs including Microsoft Word and Excel

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