Member Recertification Specialist
This position is responsible for assisting members with their recertification process/applications in person and by phone. The Member Recertification Specialist must ensure timely, effective, and efficient outreach in order to sustain membership. This includes both in-house and external outreach as needed in accordance with established productivity standards.
Essential functions are job duties and responsibilities that must be performed to accomplish the purpose/ goals of the job.
• Conduct outreach calls to existing members to assist with the recertification process based on recertification reports, achieving weekly and monthly productivity goals.
• Communicate the managed care concept and the importance of continuity, as well as promote, and educate members about the importance of renewing their Health Care Coverage to retain their Medicaid eligibility.
• Schedule personalized visits for members who need and/or request assistance with recertifying, including the timely NYSoH (Marketplace) renewal completion, and/or meet members at their sponsor sites, by appointment, to assist with recertification.
• Achieve weekly and monthly renewal goals set by management to increase overall membership.
• Schedule initial and follow-up meetings with prospective enrollees and those recertifying and make telephone contact as necessary to complete recertification or enrollment application process.
• Accurately document all member recertification activity via designated tools including Salesforce, ACDB, email to management and other tools as assigned by management.
• Explain benefits and services offered by Amida Care as requested or needed when assisting members with recertification.
• Participate in Amida Care’s renewal events and activities aimed at attracting hard to reach members; actively engage with members and potential members during and after Amida Care events.
• Ensure that all recertification activities are performed in compliance with Medicaid regulations and corporate policies.
MINIMUM JOB REQUIREMENTS
• High School Diploma or equivalent required. College degree preferred or an equivalent combination of education and relevant work experience.
• Minimum of 3 years’ experience working directly with members for a health plan or community based organization
• Successful completion of Assistors Annual Recertification Training within one month in the role and maintain certification for the duration of employment in this role
• Proficiency in Microsoft Office (word, Excel, Access, PowerPoint and Outlook) and demonstrated ability to learn and work with user-centric electronic systems and tools including a laptop and mobile phone.
• Ability to maintain regulatory requirements and Amida Care Marketing policies and procedures.
• Knowledge and/or experience with Medicaid/ Public Assistance preferred.
• Ability to read and communicate effectively in English.
• Bi-lingual Spanish preferred
• Ability to travel and work in all five boroughs of New York City. Must be able to work flexible schedule as needed.
• Ability to carry materials and supplies weighing 10 lbs. or less.
• Demonstrate understanding and sensitivity to multi-cultural values, beliefs, and attitudes of both internal and external contacts.
• Demonstrate appropriate behaviors in accordance with the organization’s vision, mission, and values.