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SalaryOver 35 years strong and fueled by 1,700 smart, passionate employees across New York state and Vermont, MVP is full of opportunities to grow. We are a nationally recognized, award-winning leader for a reason. The beating heart of our company is a wide range of employees from a diverse set of backgrounds—tech people, numbers people, even people people—working together to make health insurance better. If you are ready to join a thriving, mission-driven company where you can create your own opportunities and make a positive difference—it’s time to make a healthy career move to MVP!
Status: Full Time, Non-Exempt
Please note this is a remote position withing New York State only.
- Receives and reviews medical documentation and verifies documents are thorough and complete. Provides outreach to medical offices and sends fax communications as needed.
- Coordinates completion of authorization for UAS Assessments with vendors and ensures regulatory requirements are met.
- Participates in planning activities with Case Management Team to ensure services are in place and communicates with vendors to problem solve issues causing barriers in services.
- Organizes administrative processes to expedite approvals for membership in caseload.
- Provides appropriate follow up for submission of necessary documentation to authorize services. Follows up with vendors, members and case managers as needed.
- Has strong working knowledge of regulatory standards and compliance requirements regarding Long Term Services and Supports.
- Manages the LTSS phone queue while handling multiple assignments simultaneously.
- Confirms member eligibility and communicates with Enrollment Eligibility Team and submits service forms to reinstate or terminate member coverage and documents in the Health Management Platform.
- Works effectively on weekly and monthly reports and provides necessary follow up.
- Supports the Long Term Services and Supports programs by performing and documenting case management enrollment administrative functions which include case tracking, record keeping, coordination of member mailings, and clear and concise documentation in the Health Management Platform.
- Performs other duties as assigned.
Minimum Education: High School Diploma required. Associate degree in Health, Business or related field preferred.
Minimum Experience:
Two years administrative office experience required.
Two years experience in Healthcare, health insurance or managed care strongly preferred.
Required Skills:
- Strong interpersonal skillsto communicate with members, providers and cross-
- Demonstrated knowledge of Microsoft Suite including Outlook, Word, Excel,
- Excellent verbal and written communication skills
- Detail oriented with strong organizational andtime management skills
- Ability to work independently and prioritize multiple assignments
- Bilingual (Spanish speaking)excellent telephone/communication skills
MVP Health Care is a nationally recognized, not-for-profit health insurer caring for members in New York and Vermont. Committed to the complete well-being of our members and the communities we serve, MVP makes health insurance more convenient, more supportive, and more personal. We are powered by the ideas and energy of more than 1,700 diverse employees from all backgrounds, committed to having a positive impact on the health and wellness of everyone we serve.
At MVP, we are committed to providing competitive employee compensation and benefits packages. The base pay range provided for this role reflects our good faith compensation estimate at the time of posting. Specific employment offers and associated compensation will be made individually based on several factors, including but not limited to geographic location; relevant experience, education, and training; and the nature of and demand for the role.
In addition, we offer a comprehensive benefits package that includes:
- Considerable paid time away from work including PTO (Paid Time Off), sick time, service time off, paid holidays, and floating holidays, allowing you to take time off when it suits you best.
- Competitive 401(k) employer matching and profit-sharing program to help you save for your retirement.
- Low premium health benefits including medical, dental, and vision coverage to support your well-being and that of your family.
- Life insurance and disability coverage to ensure financial security for you and your dependents.
- An array of optional benefit plans such as accident insurance and specified disease coverage to protect you from the unexpected.
- Full tuition reimbursement (up to the IRS limit) for approved courses and programs that support continuous learning.
- A best-in-class employee Well-Being program to support all dimensions of your health and wellness.
MVP Health Care is an Affirmative Action/ Equal Employment Opportunity (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), and the Know your Rights protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at hr@mvphealthcare.com
Please apply and learn more – including how you may become a proud member of our team.
