• Transition Liaison Coordinator- MLTC

    Job Locations US-NY-Staten Island
    ID 2018-1162
    Category
    Non-Clinical- MLTC
    Type
    Regular Full-Time
  • Overview

    Coordinator will be responsible for assisting in the transitional process to accommodate an efficient and timely start of care for perspective enrollees through the said responsibilities below.  The Transitional Liaison Coordinator will receive and get guidance from the Transitional Team Leader.

    Responsibilities

    • Have a working knowledge of Microsoft Excel
    • Able to handle all telephone communication in a polite respectful manner.
    • Have the ability to work in a fast pace environment.
    • Submitting and reviewing all necessary documentation for all Disenrollment requests
    • Distinguishing various HCS/DOH files concerning Enrollments, Terminations and Rejections; relaying all pertinent information to outside parties
    • Managing various spreadsheets, including but not limited to (Active Member, 834 Log, Pending Case List, DOH required sheets, etc.)
    • Keep prospective enrollees informed of change in Medicaid status or start of care date
    • Creating all initial authorizations for new coming members (calling vendor agencies to confirm statuses, and availability, etc.)
    • Coordination with new enrollees and providers to ensure that appropriate services are placed in a timely fashion
    • Creating new enrollee charts, and NTUC chats by month
    • Adding PCP and Associated Facilities to new enrollee McKesson profiles
    • Assisting MCD Specialist, to maintain appropriate eligibility requirements
    • Opening all approved Enrollee’s and closing all dis-enrolled Member’s in McKesson and HMA
    • Running various reports to confirm all QAS Stats are accurate
    • Additional assistance with other duties as required

    Qualifications

    • High School Diploma or GED required
    • Previous experience with health plan operations preferred
    • Experience in dealing with the Managed Care industry preferred

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