Job Description
Eligibility Continuity Specialist – Bilingual Chinese Mandarin (Remote)
Rancho Cucamonga, California
Administration
Job Requisition ID:10001
Position Summary/Position
Under the supervision of the Eligibility Continuity Manager, the Eligibility Continuity Specialist will provide full Redetermination of Eligibility (RE) application assistance to IEHP Members to help maintain their Medi-Cal eligibility. Upon Member’s requests, the Eligibility Continuity Specialist will help complete the RE application, document any reported contact changes in the online Medi-Cal Eligibility portal, help prepare and submit documentations required for eligibility maintenance, and other assigned Eligibility-related duties.
This is a Bilingual (English/Spanish/Chinese/Vietnamese) position. The Team Member in this role must take a language proficiency assessment and must receive a passing score.
Major Functions (Duties and Responsibilities)
1. Strive to live and practice IEHP’s Mission, Vision, and Values (MVV) every day, and strongly commit to advance the organization’s strategic plan.
2. Conduct outbound calls to IEHP Members to help them understand the Medi-Cal Redetermination of Eligibility (RE) process and complete the RE application upon Members’ request.
3. Help Members prepare and submit any documentation required for the purpose of eligibility maintenance.
4. Develop a thorough understanding of the Medi-Cal eligibility process and resources offered by the state, county, and within IEHP, including BenefitsCal.com and reporting tools.
5. Provide best customer services that reflects our MVV to IEHP Members.
6. Proactively identify opportunities for improvements, including frictionless processes.
7. Document call results in a Customer Relationship Management (CRM) database.
8. Document and submit information using an online portal.
Major Functions (Duties and Responsibilities) Cont
Supervisory Responsibilities
Leading: Self
Experience Qualifications
Bilingual (English/Spanish/Chinese/Vietnamese) – written and verbal skills required.
Two (2) or more years of relevant Medicaid Eligibility experience. Professional phone etiquette with experience in a call center atmosphere. Experience in the performance-based environment.
Preferred Experience
Experience in a health plan or County Medi-Cal office preferred.
Education Qualifications
High School diploma or GED required.
Preferred Education
Bachelor’s degree in a related field from an accredited institution preferred.
Professional Certification
Professional Licenses
Drivers License Required
Yes, must have a valid California Driver’s License.
Knowledge Requirement
Knowledge of Medicaid (Medi-Cal) eligibility required. Knowledge of customer services phone etiquette required.
Skills Requirement
Skilled in providing best customer experience in phone calls. Maintain the professionalism when experiencing difficult calls. Able to have clear verbal communications and written documentation.
Abilities Requirement
Maintain the confidentiality of the Members. Handle all Members’ request professionally in a high-volume call environment.