• Job Description

  Req#: a2x6o6igbf0t

  
  
  Looking for meaningful work with an Organization that values you? It’s here!

  Join our team of dedicated, caring professionals in our passionate pursuit of improved access and quality of healthcare for underserved populations.

  For over 50 years, Monroe Plan for Medical Care, a not-for-profit health care services organization, has been focused on improving the health status of individuals and families who are recipients of government sponsored health insurance. Monroe Plan is the largest Care Management Agencies serving 28 counties and over 3000 members with an outstanding reputation for excellence throughout our service area!

  We’ve earned that reputation by providing quality care management focused on compassion, empowerment, and teamwork. Our award-winning work culture is built on these same principles! When you join our team, you can expect to reap the intrinsic rewards of serving others while enjoying flexible work arrangements, competitive pay, superior benefits, and a supportive, inclusive culture!

  We are currently looking for an experienced and qualified, Intake Representative for our Utilization Management team. We offer competitive pay, flexible schedules and great benefits. If you are passionate about helping individuals and working one on one with them, this might be the right fit for you. Our mission encompasses compassion, empowerment and teamwork. We believe if we are supportive and compassionate to our employees, it will spill over to our members.

  
  Intake Representative II
  Grade 205
  This is a full time position, Monday - Friday, working from home.
  The minimum and maximum annual salary that Monroe Plan believes in good faith to be accurate for this position at the time of this posting are $32,603 - $39,848. In addition to your salary, Monroe Plan offers a comprehensive benefits package (all benefits are subject to eligibility requirements) and non-monetary perks. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

  POSITION SUMMARY

  The UM Intake Representative II provides and processes information to Monroe Plan's contracted customers, business associates and participating providers to successfully resolve their telephone, email and fax inquiries. Inquiries include eligibility, referrals and claims.

  POSITION HAS DIRECT REPORTS: No

  ESSENTIAL JOB DUTIES/FUNCTIONS

  % of Time

  Essential Function

  100%

  Respond to incoming queries from Monroe Plan's contracted customers, business associates and participating providers in accordance with Medicaid, corporate service strategy and legislative requirements. Demonstrates through customer interactions a thorough understanding of contract benefits, enrollment processes, and referrals as they relate to insurance eligibility. Utilizes appropriate resource materials to effectively and accurately interpret‚ respond and resolve customer inquiries and concerns. Ability to independently handle and resolve incoming claims calls from providers. •Demonstrates through customer interactions the problem solving skills necessary to accurately and efficiently resolve customer inquiries in an organized manner, resulting in acceptable production levels. •Researches, interprets and responds to customers in a professional, efficient manner to encourage public acceptance of corporate products, services and policies. •Handles confidential information in accordance with HIPAA requirements. •Documents calls in accordance with departmental policies. •Employs strong interpersonal skills in order to handle difficult calls courteously and professionally .

  Total must equal 100% - essential functions should be completed at least 10% of the time

  OTHER FUNCTIONS AND RESPONSIBILITIES

  • Performs other duties as assigned.
  • Interacts effectively with the CO team, business partners, and internal departments. Actively participates in and contributes to the daily operations of the UM CO Department.
  • Identifies opportunities to improve processes and services. Shares with management issues that are obstacles to providing great service.

  MINIMUM REQUIREMENTS/LICENSES/CERTIFICATIONS

  • 9 months satisfactory performance as UM Intake Rep I or equivalent experience.
  • Successful completion of CSP Level II training class.
  • Satisfactory performance for 90 days taking Level II calls.
  • Must meet minimum performance requirements for position during the final 30 days of review period.
  • Must successfully meet other performance metrics as specified
  • High school diploma or equivalent.
  • 2 years of experience in a customer call center service position.
  • Effective and diplomatic oral communication skills. Good listening skills.
  • Sound reasoning and problem-solving skills.
  • Strong computer skills.
  • Ability to read, understand and follow written policies and procedures.
  • Ability to learn new skills.
  • Demonstrates cultural competence .

  PREFERRED QUALIFICATIONS

  • Experience in insurance industry. Managed Medicaid experience a plus.
  • College level experience preferred; an Associates degree or beyond a plus.

  PHI MINIMUM NECESSARY USE: This staff position PHI access will be determined based on Minimum Necessary standards. The Minimum Necessary Grid can be found on the Human Resources and Compliance Web pages.

  This job description is only a summary of the typical functions of the job, not an exhaustive or comprehensive list of all possible job responsibilities, tasks and duties. Additional responsibilities, tasks and duties may be assigned as necessary.

  Monroe Plan for Medical Care is an Equal Opportunity Employer.

• About the company

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