Job Description

DUTIES AND RESPONSIBILITIES o Responsible for assisting enrollees in selecting the most appropriate MCO and PCP, taking into account each individuals’ needs and location o Answers questions and provides information and education on programs and services. o Responds to requests, and/or takes actions on accounts or enrollment applications. o Follows standard procedures to ensure consistency, accuracy, and meeting all quality assurance requirements o Facilitates the conversation by soliciting needed information, clarifying responses, and addressing concerns. o Manages customer inquiries with consistency, accuracy, and professionalism, displaying excellent customer service skills and extensive technical program knowledge. o Follows scripted dialogues to ensure quality and maintain high accuracy rates. o Regular and predictable attendance required. o Other duties as assigned. KNOWLEDGE, SKILLS AND ABILITIES o Managing Work: Effectively managing time and resources to make sure that work is finished. Identifies more critical and less critical activities and tasks. Uses time effectively o Decision Making: Identifying and understanding issues; comparing information to make a choice; choosing a course of action carefully and wisely; taking action. Recognize issues, problems, or opportunities, and determines whether action is needed. Identifies the need for and collects information to better understand issues, problems, and opportunities. o Communication: Clearly expressing information and ideas through a variety of ways; helping individuals understand and retain the message. Organizes communication by clarifying the purpose and importance. Checks for understanding when communicating. o Contributing to Team Success: Actively participating as a member of a team to help the team complete goals. Makes suggestions for achieving team goals. Demonstrates personal commitment to the team. o Work Standards: Setting high standards of performance for self and others; taking responsibility and accountability for successfully completing work. Establishes criteria and/or work procedures to achieve a high level of quality, productivity, or service. Admits mistakes and refocuses efforts when appropriate. o Customer Focus: Making customers and their needs a main focus. Developing and keeping valuable customer relationships. Actively seeks information to understand customers' circumstances, problems, expectations, and needs. Responds quickly to meet customer needs and resolves problems JOB SPECIFICATION o Skill/Knowledge: Has substantial understanding of the job and applies knowledge and skills to complete a wider range of tasks. o Job Complexity: Works on assignments that are moderately difficult, requiring judgment in resolving issues or in making recommendations. Exhibits moderate program knowledge. o Supervision Received: Normally receives little instruction on daily work, general instructions on newly introduced assignments.

REQUIRED EDUCATION: ▪ High school diploma or equivalent

REQUIRED EXPERIENCE: ▪ Two (2) years of customer service/call center experience or equivalent. ▪ Experience working with special needs populations and/or families of special needs children. ▪ Experience or training in a health care related field ▪ Experience or training related to health care insurance, Medicaid, MCO/PCP selection, EPSDT services, and any other health care programs or similar programs administered in other states. ▪ Experience or training in the managed care industry. ▪ Experience using a personal computer and software programs and a TTY machine

Company Description

CODICE provides innovative solutions in health information management for the full lifecycle of healthcare finance and compliance operations. Our customized knowledge-based software helps manage healthcare costs. At the heart of CODICE services are our technology competencies. Paired with our unparalleled process methods, these competencies deliver solutions and results that become an integral part of our clients success. CODICE's technical expertise can be leveraged for full system development, project management or staff augmentation. CODICE areas of expertise include: SYSTEM DEVELOPMENT: Fully customized development from requirements to testing. ENTERPRISE CONTENT MANAGEMENT: System implementations for content management, digital assets, web content and record keeping. SYSTEM INTEGRATION: Expert integrations using open standards, APIs, and a comprehensive toolkit to seamlessly link applications. DATA WAREHOUSING & BUSINESS INTELLIGENCE: Data collection and analysis from multiple sources into a single access point portal that provides tools for key business functions.