Office Service Clerk - Call Center

Office Service Clerk - Call Center

PAY RATE - $ 18.22

JOB SUMMARY: This position acts as a telephone triage agent to various 800 hotlines for the HealthChoice and Acute Care Administration in the Division of HealthChoise Customer relations by providing customer service and resolution of recipient and provider concerns for various Medicaid programs which include but are not limited to HealthChoice, Medicaid programs, Maryland Children's Health Program (MCHP), Family Planning program. All inquiry and Complaint calls document the enrolled and provider problems and issues in the Provider Recipient Ombudsman Management Information System (PROMIS). This also includes education of recipients and providers regarding navigation and access of the Medicaid system by reviewing state and federal regulations, policies and procedures. The agent is required to triage all medical complaints from recipients and providers in the Medicaid Programs and is required to document the complaint/issue in the PROMIS database. All complex complaints are referred to the Complaint Resolution Unit within the Division of Outreach and Care Coordination.

ESSENTIAL DUTIES & RESPONSIBILITIES:

• Answer all incoming phone calls in accordance with MMA policies and procedures and respond to client inquires.
• Prepare client letters based upon route slips restrictions, to include copying and mailing as deemed necessary.
• Scan and file all client correspondence, letters and documents.
• Process all incoming mail to include opening, stamping, indexing, and distributing mail and correspondence to the appropriate designee.
• Retrieving and responding to phone messages, sorting mail, entering mail and notes into the system files, documenting, corresponding and returning claims for review.
• Retrieving and responding to email correspondence in accordance with MMA policies and procedures and responding to client inquires.
• Provide other clerical support services as necessary such as photocopying, scanning, preparing outgoing mail, processing case closures, performing system notes, screen updates, and providing assistance with special assignments.

EDUCATION AND/OR EXPERIENCE:

• High School diploma or equivalent preferred
• Basic Math skills

CERTIFICATES, LICENSES, REGISTRATIONS:

• None

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

KNOWLEDGE, SKILLS, AND ABILITIES:

• General experience working in an office setting
• Ability to perform repetitive motion for long periods of time

PHYSICAL REQUIREMENTS:

Must be able to lift boxes up to 35 lbs. May be required to regularly sit for extended periods of time, walk, reach with hands/arms with full range of motion. Regularly required to talk and hear

WORK ENVIRONMENT: The noise level is usually moderate.

REPORTS TO: Manager on duty

EOE/MFDV