Medicaid Recipient Communications Specialist
Infocrossing Healthcare Services, Inc. (Jefferson City, Missouri)

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General Job Description:

Performs a wide variety of responsibilities based on established guidelines and policies.  Primary responsibility of the position is to provide accurate and timely responses to telephone and written inquiries from Medicaid recipients in a courteous and professional manner. 

 

Responsibilities:

Interpret, analyze and explain complex rules and claim data through a variety of resources.    Answer incoming phone lines to respond to health care recipient questions regarding the specific health care program in a courteous and professional manner.Review, research, and respond to written inquiries within 30 days of receipt.Utilize Medicaid manuals to ascertain program policies.Identify services covered under various Medicaid programs.Follow specifications mandated by the state Medicaid contract and maintain an in-depth knowledge of the Medicaid state and federal rules and regulations.Comply with all contractual service delivery terms.Maintain a positive working relationship with various customer work groups to contribute to customer satisfaction.Access system to determine bill and payment status.Refer Medicaid recipients to medical providers in their area.Perform other duties as assigned or requested.    

Qualifications/Education Required:

Exceptional customer service skills in the area of telephone and support.  3 years of work experience in one or more of the following fields; healthcare provider relations, insurance claims processing, medical billings, medical diagnostic and procedure coding.  Healthcare regulations development and/or enforcement of similar work of which 2 years must have been in advanced capacity.  Education from an accredited university may be substituted on a year for year basis for the general experience and for a maximum of one year on the specialized experience.  Years of work experience in the area of customer service phone skills may be substituted on a year for year basis for the general experience. Medicaid experience is preferred.

Equal Opportunity Employer

Email Resumes to: janel.schnieders@infocrossing.com