Operations Specialist - Bronx

ElderServe Health is a mission-driven, nonprofit managed care organization serving the New York metropolitan area. ElderServe provides long-term services and supports to more than 20,000 older adults and adults with disabilities across New York City, as well as Westchester, Nassau, and Suffolk Counties. ElderServe primarily serves a frail and elderly membership who is predominantly dual-eligible and enrolled in Medicaid managed long-term care, Medicare-only and integrated Medicaid-Medicare plans. The CareSource and ElderServe affiliation addresses these critical long-term care needs to help members be as healthy and independent as possible.

Job Summary:
Responsible for the clerical, administrative, customer service and coordination activities to support care management and member services. Responsibilities may include ordering of services and supplies and assuring their timely delivery; member services representatives' duties, including inbound and outbound call responsibility and other duties as needed to support care management and member services. The Operations Specialist supports the provision of care plans. S/he may order services for members (equipment and supplies, transportation, personal care, etc.), take requests for services from members, assist Nurse Care Managers with member interactions, and take authorizations from Nurse Care Managers for processing. S/he will answer incoming calls, make outgoing calls as requested and/or review member care management survey results identified issues requiring follow up.

Essential Functions:

• Acknowledge a patient's, visitor's and customer's presence immediately.

• Smile and introduce yourself when appropriate.

• Create a home-like, healing environment by being courteous and respectful to all.

• Convey a positive attitude by being friendly, kind and interested in helping others.

• Always be willing to offer assistance to those in need.

• Give your full attention to what the customer is saying. Listen without interruption.

• Acknowledge the customer's requests and concerns. Respond in a timely manner.

• Practice proper elevator etiquette

• Use proper telephone etiquette

• Wear identification badge correctly at all times.

• Contribute to effective teamwork in everything you do.

• Is responsible and cooperative with supervisors, fellow employees, residents, and visitors.

• Is open to suggestions and constructive criticism.

• Accepts constructive criticism as evidenced by appropriate changes in behavior.

• Maintains professional attitude.

• Maintains professional appearance.

• Handles conflicts as a professional.

• Utilizes established channels of communication.

• Recognizes limitations and seeks assistance appropriately.

• Promotes harmonious relationships and favorable attitudes among departments.

• Adheres to the Hebrew Home's standards of e-mail etiquette.

• Perform any other job related duties as requested.

Education and Experience

• High School or GED required

• Some College/Business School preferred

• Bilingual (fluent in Spanish, Russian or Chinese) required

• Familiarity with the healthcare environment (Medicaid/Medicare) preferred

• Previous Medical billing/terminology experience preferred

• Prior field experience working with therapists/other licensed medical professionals preferred

Competencies, Knowledge and Skills

• Demonstrates knowledge of Medicare and Medicaid regulations.

• Demonstrates ability to utilize Microsoft Office Products.

• Demonstrates working knowledge of all federal, state, local and regulatory agency requirements as related to the department and position.

• Demonstrates the ability to integrate age specific requirements with individual developmental, mental, social and cultural needs when performing procedures for geriatric members.

• Excellent verbal and written communication skills

Licensure and Certification:

Working Conditions

• General office environment; may be required to sit or stand for extended periods of time

• Travel is not typically required

Employment in this position is conditional pending successful clearance of a criminal background check. If the criminal background results are unacceptable, the offer will be withdrawn or, if employee has started in position, employment in position will be terminated.

Compensation Range:
$0.00 - $0.00 CareSource takes into consideration a combination of a candidate's education, training, and experience as well as the position's scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee's total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type:
Hourly

Competencies:
- Fostering a Collaborative Workplace Culture
- Cultivate Partnerships
- Develop Self and Others
- Drive Execution
- Influence Others
- Pursue Personal Excellence
- Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds.