Operations Specialist - DME - Bronx at CareSource

New York, New York, United States -

Full Time

Start Date

Immediate

Expiry Date

05 Jun, 26

Salary

66000.0

Posted On

07 Mar, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Clerical Support, Administrative Support, Customer Service, Coordination, Care Management Support, Service Ordering, Supply Ordering, Inbound Calls, Outbound Calls, Authorization Processing, Microsoft Office, Medicare Regulations, Medicaid Regulations, Verbal Communication, Written Communication, Teamwork

Industry

Insurance

Description

Job Summary: Responsible for the clerical, administrative, customer service and coordination activities to support care management and member services. Responsibilities may include ordering of services and supplies and assuring their timely delivery; member services representatives' duties, including inbound and outbound call responsibility and other duties as needed to support care management and member services. The Operations Specialist supports the provision of care plans. S/he may order services for members (equipment and supplies, transportation, personal care, etc.), take requests for services from members, assist Nurse Care Managers with member interactions, and take authorizations from Nurse Care Managers for processing. S/he will answer incoming calls, make outgoing calls as requested and/or review member care management survey results identified issues requiring follow up. Essential Functions: Acknowledge a patient’s, visitor’s and customer’s presence immediately. Smile and introduce yourself when appropriate. Create a home-like, healing environment by being courteous and respectful to all. Convey a positive attitude by being friendly, kind and interested in helping others. Always be willing to offer assistance to those in need. Give your full attention to what the customer is saying. Listen without interruption. Acknowledge the customer’s requests and concerns. Respond in a timely manner. Practice proper elevator etiquette Use proper telephone etiquette Wear identification badge correctly at all times. Contribute to effective teamwork in everything you do. Is responsible and cooperative with supervisors, fellow employees, residents, and visitors. Is open to suggestions and constructive criticism. Accepts constructive criticism as evidenced by appropriate changes in behavior. Maintains professional attitude. Maintains professional appearance. Handles conflicts as a professional. Utilizes established channels of communication. Recognizes limitations and seeks assistance appropriately. Promotes harmonious relationships and favorable attitudes among departments. Adheres to the Hebrew Home’s standards of e-mail etiquette. Perform any other job related duties as requested. Education and Experience High School or GED required Some College/Business School preferred Bilingual (fluent in 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 Competencies, Knowledge and Skills Demonstrates knowledge of Medicare and Medicaid regulations. Demonstrates ability to utilize Microsoft Office Products. Demonstrates working knowledge of all federal, state, local and regulatory agency requirements as related to the department and position. Demonstrates the ability to integrate age specific requirements with individual developmental, mental, social and cultural needs when performing procedures for geriatric members. Excellent verbal and written communication skills Licensure and Certification: Working Conditions General office environment; may be required to sit or stand for extended periods of time Travel is not typically required Background Check Employment in this position is conditional pending successful clearance of a criminal background check. If the criminal background results are unacceptable, the offer will be withdrawn or, if employee has started in position, employment in position will be terminated. Compensation Range: $41,200.00 - $66,000.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Hourly Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

Responsibilities

The Operations Specialist is responsible for clerical, administrative, customer service, and coordination activities to support care management and member services, including ordering supplies and services and handling member interactions via phone. This role involves supporting care plans by ordering necessary services like equipment and transportation, and processing authorizations from Nurse Care Managers.