Bilingual Field Enrollment Advocate - Spanish or Mandarin/Cantonese

The Entitlement Advocate provides Healthfirst Medicare Advantage Plan(MAP), Managed Long-Term Care Plan(LTC), Dual eligible Medicare Plan and Nursing Home members and prospects with obtaining and retaining of financial entitlements for which they are eligible. This enables prospects and members to maintain the highest level of independence both at home and within their communities. Working under the direction of the Entitlement Manager and Team Leads, maneuvers multiple tasks independently with a fast paced proactive vs. reactive approach to changing priorities. Frequently communicates moderately complex information and interacts through electronic documentation tools. This is a paperless work environment requiring daily hands-on administration of multiple electronic Patient Health Information databases and security requirement tools such as encryption.

Responsibilities

Handle inbound and outbound calls to and from customers; Screen all incoming calls and handle accordingly; Transfer calls to appropriate staff, unit, or department; Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New Medicaid Applications; Outreach Senior Health Partners, CompleteCare, and Life Improvement Plan members according to approved scripts; Research ePACES and/or Marx for Medicaid and Medicare eligibility, exclusion, and exemption codes; Document all client calls/outcomes in database systems; Educate potential members on plan features and benefits and eligibility for enrollment; Complete Medicaid applications for new enrollees and renewals; Assist prospects to remove Medicaid restriction codes and convert Marketplace Medicaid to Community Medicaid; Conduct home visits and appointments to complete applications and obtain required documentation; Submit documentation to Human Resource Administration or Local Department of Social Services; Track Medicaid conversions and coverage of submitted applications; Serve as liaison between parties and member advocate; Contact and assist current members due to recertify their healthcare coverage; Maintain records on every member to show coverage status and timing of re-certification; Prepare/submit monthly reports

Requirements

High school diploma or GED from an accredited institution; Member facing or customer service experience; Be able to work 9am-5:30pm schedule; Be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County; Capability to work in a Hybrid Schedule (remote/office/field); Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint; Bilingual (Spanish or Mandarin/Cantonese); Be able to communicate and engage with the leadership team on virtual platforms such as Zoom or Microsoft Teams chat as well as in person

Nice to have

Associate degree from an accredited institution plus 1 year of related work experience including inbound and outbound call center within a healthcare environment; Telephonic experience with frail adult or elderly population; A solid understanding of the value of integrated care; Experience in health insurance, home care environment, acute, sub-acute, long-term care setting, or managed-long term care; Have access to a vehicle with valid proof of insurance and be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County; Experience managing member information or appointments in a shared network environment using paperless database modules; Adept at operating within a multi-cultural work environment; Bilingual; Prior experience with Medicaid /Medicare Savings Program

Benefits

Medical, dental and vision coverage; Incentive and recognition programs; Life insurance; 401k contributions