Field Health Benefits Coordinator

Newark, NJ, United States

About Conduent:

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.

Job Description:

Field Health Benefits Coordinator-Newark New Jersey

$20/hr

Provides courteous and accurate information on NJ FamilyCare to customers within an office and call center setting. Assists beneficiaries by providing program and managed care information, application assistance, and assistance in enrolling in an HMO. Conducts individual or group presentations throughout the community on NJFamily Care Program and the benefits of managed care. Processes eligibility applications and determines eligibility for the NJFamily Care program and refers beneficiaries that are potentially eligible for Medicaid to DMAHS for review. Enters eligibility information into a web-based computer system and references other NJ-specific databases as appropriate. Follows up with beneficiaries with correspondence, performs file updates as information comes in, and assesses service/information.

Essential duties may include, but are not limited to:

Assists walk-in and telephone consumers with completing new and renewal applications, HMO selection forms and answers questions about the program. Conducts presentations to educate consumers about NJFC and the benefits of managed care within an office and call center setting.

Informs customers about services available and assesses customer needs.

Provides clear, complete, accurate and objective information based on full understanding of program requirements.

Conducts presentations at Community Based Organizations, community events and home visits with some evening and some weekend events.

Builds relationships with the community, and advocacy groups.

Responds to telephone inquiries and complaints in a call center environment using standard scripts and procedures.

Reviews application information on the web-based system and associated imaged documents.

Verifies data displayed for the application is consistent with information on imaged documents.

Identifies missing information and initiates requests for generation of missing information notices.

Initiates telephone calls to beneficiaries to follow-up and confirm information, as necessary.

Documents missing information in the web-based computer system.

Enters, reviews and processes missing information when documentation is received.

Determines eligibility for NJ Family Care according to the NJ Family Care regulations/guidelines by reviewing documentation to accurately enter data into a web-based computer system and following procedures for running automated eligibility rules; prepares correspondence for missing information as appropriate; makes outbound calls to obtain, clarify, or validate information.

Participates in and contribute to the quality improvement process.

Participates in training sessions.

Other duties as assigned.

Minimum Experience Requirements

Minimum of two years customer service experience in a healthcare field.

Experience working with people representing diverse backgrounds preferred.

Experience working with detailed data and following defined procedures.

Two to five years experience in the determination of beneficiary eligibility for public assistance is desired.

Required skills/abilities

Demonstrated data entry accuracy and ability to enter data from scanned images.

Ability to interpret and apply program policies and procedures as appropriate.

Ability to use basic arithmetic procedures to determine household size and income and determine program eligibility.

Ability to establish and maintain effective working relationships with beneficiaries, co-workers, and the community.

Ability to apply logical reasoning to make timely, effective decisions.

Ability to communicate complex information effectively.

Ability to evaluate information received from or about beneficiaries for accuracy and completeness.

Ability to maintain self-control under stressful situations.

Ability to handle multiple tasks and meet deadlines, flexibility under pressure.

Ability to work with people of diverse backgrounds

Ability to maintain strict confidentiality.

Capable of working independently

Excellent verbal, written, and interpersonal skills

Proficient in use of personal computer, including MS Office Suite

Bilingual capabilities a plus

Knowledge of Medicaid and managed care programs a plus.

Knowledge of available state and federal human service assistance programs and their eligibility requirements a plus. Overtime, evening, and some weekend hours. Reliable transportation.

35 wpm Typing required.

Closing:

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduents ADAAA Accommodation Policy.

At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.