
1001 - 5000 employees
Founded 1993
🛡️ Insurance
🏥 Healthcare
⚕️ Healthcare Insurance
Insurance • Healthcare • Healthcare Insurance
Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.
🕒 June 18
🦌 Connecticut, New Jersey, +1 more states – Remote
💵 $34.9k - $52k / year
⏰ Full Time
🟡 Mid-level
🟠 Senior
🦅 H1B Visa Sponsor
👻 Ghost score 46%
🗣️🇪🇸 Spanish Required
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1001 - 5000 employees
Founded 1993
🛡️ Insurance
🏥 Healthcare
⚕️ Healthcare Insurance
Insurance • Healthcare • Healthcare Insurance
Healthfirst is a health insurance provider dedicated to helping New Yorkers access affordable health coverage for individuals and families. With over 30 years of experience, Healthfirst offers a range of plans including Medicaid managed care, Medicare Advantage, long-term care, and essential health plans. The company focuses on providing quality healthcare options, comprehensive benefits, and support to ensure members can maintain their health and well-being.
• Assist care/case managers with non-clinical activities, including creating cases and events • Manage authorizations • Provide telephonic outreach to members, providers, and community-based organizations • Handle member mailings • Fax clinical requests and Individual Health Care Plans on behalf of care/case managers • Provide customer service regarding authorization updates, coordinating care, DME outreach, appointment scheduling, and screening assessments • Handle provider calls regarding authorizations, referrals, visits, tests, and faxed care plans • Manage authorization requests and corrections from members, providers, call centers, and care management teams • Complete member and provider notification calls • Escalate calls to appropriate departments • Manage high volumes of tasks and caseloads from multiple queues • Meet or exceed performance, quality, and productivity measures • Document accurate member information in compliance with internal procedures • Follow established policies and procedures to address member and provider issues timely and accurately • Communicate member issues or needs and monitor member screening to improve quality and cost outcomes • Comply with HIPAA and maintain PHI confidentiality • Perform additional duties as assigned
• High School diploma or GED from an accredited institution • Prior experience in a customer service environment • Working experience in a fast-paced environment • Proficient in Microsoft Office Suite applications including Excel, Word, and Outlook • Spanish fluency • Knowledge of medical terminology • Experience in managed care or another area of the healthcare industry working in a Call Center environment or Care/Case Management Department • Experience navigating multiple technologies including a Customer Relationship Management System • Proven track record of exercising independent thinking, problem solving and achieving goals • Excellent verbal and written communication • Ability to document grammatically correct emails, communications, and presentations
• Medical coverage • Dental coverage • Vision coverage • Incentive and recognition programs • Life insurance • 401k contributions • Competitive compensation and benefits package
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