Member Eligibility Coordinator (Bilingual)

Brooklyn NY 11201 Brooklyn 3 15 MetroTech Center SWH

Job Description

Candidates must be fully available to work 9am-5pm Monday-Friday *Bilingual candidates, particularly English/Spanish, strongly preferred


This position works directly with members and staff to ensure that members have access to assistance in completing required eligibility and redetermination paperwork in a timely manner. This role may provide in home assistance with eligibility paperwork and phone coordination with external resources to facilitate sending documentation to state enrollment centers.
  • Manages the monthly suspended eligibility list by contacting members in a timely fashion to see if assistance is needed.
  • Provides timely assistance completing state redetermination paperwork to members in their homes or alternate care settings.
  • Identifies and facilitates appropriate waiver referrals including completion of the state application for members who no longer meet state eligibility requirements.
  • Submit timely applications and follow up paperwork to state enrollment centers on behalf of members.
  • Manages the weekly list generated from the Enrollment department to identify members who are not on the suspended eligibility list and are in jeopardy of losing coverage. 
  • Follows up on alerts regarding member eligibility issues and provides appropriate assistance and outreach to members and their families.
  • Document all actions including home visits, phone calls and mailings in the member centralized enrollee record in a timely manner.
  • Reviews the list of dually eligible members at the end of each month that have not regained eligibility and advise them of need to select a Part D plan; documents as appropriate.
  • Prepares monthly reports with disposition of suspended eligibles to share with company departments.
  • Makes recommendations for policy and procedure changes aimed at member retention, workflow efficiencies and member satisfaction.

General Job Information

Title

Member Eligibility Coordinator (Bilingual)

Grade

20

Job Family

Operations Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

8/20/2019

Date Requisition Created

8/20/2019

Work Experience

Bilingual, Healthcare

Education

Bachelors (Required)

License and Certifications - Required

DL - Driver License, Valid In State - Other

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • Must possess a valid driver’s license and have reliable transportation.
  • 2+ years of experience working in public benefits counseling.
  • Previous experience working at an Aging Service Access Provider (ASAP), health benefits counseling or with elder service agencies an advantage.
  • Proven capability of building relationships and collaborating with providers, community and social service organizations, members and the multidisciplinary team.
  • Experience working with low income elder population.
  • Ability to independently review and maintain up-to-date knowledge of Medicaid and Medicare eligibility criteria and regulations.
  • Self starter with high level of accountability and responsibility for outcome of care.
  • Excellent interpersonal skills.
  • Excellent verbal and written communication skills.
  • Creative thinker with strong problem resolution skills.
  • Highly organized and able to manage multiple priorities appropriately.
  • Strong working knowledge of Microsoft Office Product Suite.  Ability to quickly learn new software applications as needed. 
  • Bilingual preferred.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.