Will this position be required to work onsite for any reason at any time? Yes
Engagement Description –
Under general supervision is responsible for assisting and supporting management in the execution, evaluation, recommendation, establishment, implementation and of production workflows, work processes for systems, reporting and new products/programs to improve customer service levels and overall quality.
Top 3 Required Skills/Experience –
- Handle escalated servicing issues by way of CMS' Complaints Tracking Module.
- Ability to work with external parties directly, such as providers and members, to resolve issues/problems and effectively communicate findings.
- Work cross departmentally to address enrollment, claims, benefit, eligibility, and billing matters.
Required Skills/Experience – The rest of the required skills/experience. Include:
- Maintain confidentiality of all information processed.
- Assist and support in the planning, coordinating, developing, and implementing of approved projects which are Divisional and/or Corporate in scope to enhance the overall efficiency of operational procedures, methods, controls, and performance.
- Analyze, process and/or expedite operational transactions; this may include timely resolution of problems.
- Participate in systems testing, develop procedures/controls and provide recommendations for the ongoing improvement of the updated process.
- Provide leadership team with status of projects; issue, communicate and recommend policy decisions to achieve project objectives.
- Utilize and maintain available corporate production and reporting systems; produce routine and non-routine reports, presentations, letters communications and graphics.
- Assist personnel (both internal and external) by answering questions, supplying information and training.
- Develop and maintain an effective working relationship with customers or partners
Preferred Skills/Experience – Optional but preferred skills/experience. Include:
- Excellent analytical, organizational, planning, and follow-up skills.
- Ability to work collaboratively in a team environment, including remotely,
- Excellent verbal and written skills, including expertise in writing for digital and social media and video,
- Ability to exercise independent judgment, meet deadlines and deliver on projects while working under limited supervision.
- Ability to comprehend complex company documents, procedures, and policies, and distill these into easy-to-understand language that supports corporate strategy.
- Ability to speak effectively before external and internal groups.
- Proficient in current industry standard PC applications and systems including Microsoft Office.
- Ability to work in a team setting and independently, and under tight deadlines.
- Ability to build trust and relationships with internal and external customers.
- Ability to maintain confidentiality.
- Ability to work with a variety of variables where limited standardization exists.
- Resourceful problem solver with ability to formulate and execute plans efficiently and effectively.
Education/Certifications – Include:
- High School Graduate or GED equivalent required. Three (3) to five (5) years of experience with benefits and procedures as related to assigned department.
