Job Description
Overview
The challenges of affordable healthcare continue to create new opportunities. Elderplan and HomeFirst, our Medicare and Medicaid managed care health plans, are outstanding examples of how we are expanding services in response to our patients' and members' needs. These high-quality healthcare plans are designed to help keep people independent and living life on their own terms.
The MJHS Difference
At MJHS, we are more than a workplace; we are a supportive community committed to excellence, respect, and providing high-quality, personalized health care services. We foster collaboration, celebrate achievements, and promote fairness for all. Our contributions are recognized with comprehensive compensation and benefits, career development, and the opportunity for a healthy work-life balance, advancement within our organization and the fulfillment of having a lasting impact on the communities we serve.
Benefits include:
- Tuition Reimbursement for all full and part-time staff
- Generous paid time off, including your birthday!
- Affordable and comprehensive medical, dental and vision coverage for employee and family members
- Two retirement plans! 403(b) AND Employer Paid Pension
- Flexible spending
- And MORE!
MJHS companies are qualified employers under the Federal Government’s Paid Student Loan Forgiveness Program (PSLF)
Responsibilities
-Enters enrollee data and clinical information into Market Prominence (MP) and ensures the
completeness and accuracy of the demographic information to successfully manage and report outcomes to leadership and to governing bodies.
-Functions in tandem with teammates to ensure all NTUCs are closed promptly upon receiving formal NTUC note.
-Accurately enters request for service authorizations into HealthRules Health Rules Payor in
accordance to department guildelines.
-Completes enrollment acceptance or deferral calls according to specified deadlines and ensures to document accordingly in MP.
-Provides exceptional customer service during phone calls received and outgoing on the ACD line.
Qualifications
- High School diploma
- Bachelor’s degree preferred
- With Bachelor’s degree; minimum of one year of experience in Managed Care, provider billing, and/or customer service.
- Without Bachelor’s degree, minimum of three (3) years of experience, as above
- Knowledge of Microsoft Office