Bilingual Sr Retention Advocate

Bilingual Sr Retention Advocate

Requirements

• Minimum Education: High School diploma or GED
• Prior experience with Medicaid /Medicare/Medicare Savings Program
• Experience in inbound and outbound call center within a healthcare environment
• Have access to a vehicle and be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County
• Well organized, detail oriented, and able to adapt to procedural and other business information changes
• Strong data entry skills, must be able to maintain monthly spreadsheets for tracking and statistical purposes
• Must Speak Mandarin/Cantonese, Spanish or Haitian/Creole.

Responsibilities

• Contact member or primary caregiver by phone or letter to arrange a telephonic or in person interview to assess Medicaid/Medicare/Medicare Savings Program eligibility. Ensures all calls are in accordance to approved Healthfirst scripts
• Has full and complete access to patient records and reports as well as to personal/financial profiles and documents, always calling for the utmost integrity
• Serves as an advocate between all parties maximizing the participant’s support network and obtaining needed services
• Research ePACES and/or Marx for Medicaid and Medicare eligibility, exclusion, and exemption codes
• Consult with Human Resource Administration (HRA)/Local Department of Social Services (LDSS) Medicaid staff as needed and report to supervisor any need for HRA/LDSS consultation
• Track the Medicaid/Medicare/MSP status for all members on an ongoing basis until all member entitlements are gained
• Completes Medicaid/MSP application in a timely, organized fashion and assists participant or primary caregiver in the completion of the application
• Assists in collecting all required documents for applications
• Submit documentation to HRA/LDSS within specified timeframe to assure Medicaid coverage for participant
• Monitor all applications according to HRA/LDSS/Social Security office/Medicare time frames
• Documents all client calls /outcomes in database system and spreadsheets
• Responsible for prolonged cycles of work, must maintain accurate data and be able to present it and follow up promptly
• Prepare/submit monthly reports to Management

Preferred Qualifications

• Associate degree from an accredited institution
• Prior experience working with the 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 (LTC) setting or managed-long term care (MLTC)