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Medicaid Application Processing & Customer Service Specialist (Full-time)

Department: PCG Health
Location: Medford, MA

Medicaid Application Processing & Customer Service Specialist (Full-time) in Medford, MA

We are seeking highly professional and organized Applications Processing & Customer Service Specialists with outstanding customer service and communication skills, including excellent writing skills. This position is responsible for the accurate enrollment of patients into Medicaid services. The first six months of this role will involve training in and working within the Medicaid applications process along with its associated computer applications. After this time, we will be introducing Call Center/Customer Service responsibilities to those who have shown acumen for these tasks.

Full medical, dental, and vision benefits are offered for this position including 401k, life insurance, short and long-term disability, and 10 days of accrued paid time off within first year of employment.

This role will require 40 hours of work per week.

Responsibilities

  •  Identify and request documents as needed for products and services, such as: fact sheets, enrollment forms, etc.
  •  Effective follow up on outstanding documentation. Tasks include:
    • Coordination of outreach to patients, sales or responsible parties
    • Initiate all prior authorizations needed for services based on patient’s insurance
    • Attach all forms to patient medical record upon successful processing
  •  Manage documents in queue to ensure:
    • Deadlines for service are met; process all enrollments received by noon time same day
    • Work across all regions for enrollments
    • Prioritize emergency visits and same day add-ons as needed
    • If fax server work is mislabeled, communicate to Team Lead and/or Operations Manager for mislabeling process
  •  Update computer system as required for documentation of all insurance information obtained from carriers for associate resources
  •  Ensure clear, concise notes added to patient record for any compliance reasons and follow up as needed
  •  Scan original documents into the computer system and attach to appropriate patient record when applicable
  •  Update Managers/Team Leads with feedback from customers to improve services
  •  Other duties and tasks may be assigned as appropriate or necessary including customer service work over the phone while simultaneously using computer programs during conversations (after the six-month training and assessment period has been completed.)

Qualifications

  •  High school diploma required, Associate degree preferred
  •  Excellent interpersonal skills and a strong ability to communicate both verbally and in writing
  •  Good working knowledge of Medicare and Medicaid across multiple states
  •  Comfortable in learning and documenting third party insurance companies and how they relate to MassHealth Medicaid services
  •  Must be able to type and navigate multiple MassHealth computer applications
  •  Highly organized, can work in a fast-paced environment
  •  Comfortable and effective working with both custom and “off the shelf” computer applications
  •  Self-motivated and can work effectively with minimal supervision

All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, marital status, age, national origin, protected veteran status, or disability. VEVRAA Federal Contractor.  

Staffing Solutions Organization LLC is an e-Verify participant.

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