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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.
Job Responsibility:
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 guidelines
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
Requirements:
High School diploma
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
Nice to have:
Bachelor’s degree preferred
What we offer:
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)