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Form of workJob Description
List of Duties / Position Description:
1. Reviews paper and electronic claims for Medicaid/Long-Term Care services rendered to participants enrolled with Sunshine Health Plan who are assigned to Little Havana.
2. Arranges and provides training to providers on how to bill using our Provider Claims Portal.
3. Solves issues encountered by providers while processing claims in person, by email or telephonically through our established Provider Hotline.
4. Maintains quality customer service by following good customer service practices and responding to customer inquiries in a timely and professional manner.
5. Reviews claims and checks status of inquiries and adjustments.
6. Protects operations by keeping claims information confidential.
7. Performs data entry and filing.
8. Performs other duties as assigned.
Minimum Requirements:
1. High School Diploma or equivalent.
2. 2 years’ experience in a similar position.
3. Excellent customer service skills.
4. Strong analytical and organization skills.
5. Good interpersonal and communication skills.
6. Must be bilingual (English/Spanish).
The Rainbow Intergenerational Learning Center and Child Care Program provides an opportunity for children to develop their maximum potential. The service is offered to working for low-income families. By providing them with access to safe, quality child care services, children of low-income families are prepared to compete on an equal basis with other children of better economic means.
By identifying the obstacles that prevent children from learning, the program enables its children to develop the skills necessary to succeed in their school life.
In addition, parents will find a safe, professional, loving, and culturally sensitive environment for children while they become better informed on issues relative to child rearing.
Rainbow Child Care Services are offered to children between the ages of 0 through 5. This program is offered on a sliding scale fee and subsided services are also available.
