Responsible for peer evaluations of completed NYS Medicaid a nd Family Health Plus renewal a pplication a nd missing information documents for a ccuracy in a ccordance with Federal a nd State regulations a nd department a pproved Policies a nd Procedures
Responsible for entering a nd submitting error findings using department specific Quality Control tools
Complete the renewal processing for a ll inaccurate renewal a pplications a nd missing information tasks reviewed
Provide feedback to quality control supervisor(s) giving specific reasons for variances, a nd respond to dispute findings when necessary
Meet a nd maintain quality control standards a s set by the quality control department
Remain up-to-date on policies a nd procedures a s set by the quality control department
Performs other duties a s may be a ssigned by management.
The New York State Department of Health has contracted with MAXIMUS to support the development a nd operations of a centralized statewide Enrollment to process a pplications a nd renewals for a portion of those eligible for New York State’s public health insurance programs. The Enrollment Center a ugments the role of the local Departments of social services by providing a dditional capacity for the processing of enrollment a nd renewals, a mong other responsibilities. This particular position will primarily be working with the state's Family Planning Benefit Program, which is for women a nd men of childbearing a ge who need family planning services. A pplicants must meet program guidelines to qualify.
The Ideal Candidate will Possess the Following A dditional Education a nd Experience:
Experience in a quality a ssurance role, preferably in a call center or customer service environment.
Understanding of standard quality procedures, with preference for ISO a nd/or Purdue qualification experience.
Experience with developing or maintaining policies a nd procedures documentation.
Experience in working directly or indirectly with disadvantaged populations
Reporting experience, including report development a nd quality reporting
Experience with MS Office programs, including Word, Excel a nd A ccess.
Experience with quality monitoring in a customer service environment
Excellent organizational, written, a nd verbal communication skills
A bility to perform comfortably in a fast-paced, deadline-oriented work environment
A bility to work a s a team member, a s well a s independently.
MAXIMUS (NYSE: MMS) is a leading health a nd human services a dministrator for governments in the United States, United Kingdom, Canada a nd A ustralia. We deliver a dministrative solutions to improve the cost effectiveness, efficiency a nd quality of government-sponsored benefit programs a cross the globe. Operating under our founding mission of Helping Government Serve the People ®, we have more than 7,000 employees located in more than 220 offices worldwide. MAXIMUS is a n A ffirmative A ction a nd Equal Opportunity employer.
Education Required: High School Diploma or GED
Education Preferred: A ssociates a nd/or Bachelors degree from a n a ccredited college or university
Technical Skills / Knowledge Preferred: Proficiency in Microsoft Office (Word a nd Excel) a nd bilingual capabilities
Subject Matter Expertise/Experience Required: 0 - 2 years of related experience
Subject Matter Expertise/Experience Preferred: Experience working with culturally/linguistically diverse a nd disadvantaged populations in a courteous a nd effective manner
Personal/Soft Skills: Customer service, organizational, interpersonal written a nd verbal communications skills, a bility to interact courteously a nd effectively with a variety of people, a bility to perform comfortably in a fast-paced, deadline-oriented work environment, a bility to work a s a team member, a ttentional to detail, a s well a s independently a nd a bility to work under standards-based performance measures
Duties / Responsibilities:
1. Provide info to customers in a courteous, polite a nd professional manner
2. Perform a ccurately a ll data entry
3. A ssist customers in problem resolution
4. Receive a nd respond to telephone calls
5. A nswer questions of a general nature a nd direct incoming calls
6. Initiate follow-up calls to customers
7. Maintain confidentiality a nd security of information
8. Must be a ble to take direction from a ppointed Mentor/SME for training purposes or when immediate supervisor is not a vailable
9. Operate multi-line phone system, a nswer incoming telephone calls a nd perform other clerical duties proficiently a nd professionally
10. Respond to needs, questions a nd concerns of internal a nd external customers
11. Comply with current a nd updated policy a nd procedures
12. Perform other duties a s may be a ssigned by management
MAXIMUS offers a comprehensive benefits package including:
Healthcare Insurance (medical, dental, vision)
Short a nd Long Term Disability Insurance
Life/ A ccident Insurance
Flexible Spending A ccounts (FSA)
401(k) Retirement Plan with company match
Our benefit program a lso includes paid holidays, PTO, tuition reimbursement, a nd supplemental insurance ( a uto a nd pet insurance discounts, legal plan, a nd credit union).
MAXIMUS (NYSE:MMS) is a leading health and human services administrator for governments in the United States, United Kingdom, Canada and...