Insurance Verification Specialist or Case Management Assistant

Seeking professionals with experience in health insurance or Medicaid verification to support Medicaid-eligible members under the HIPP / Premium Assistance Program. The role involves insurance verification, eligibility documentation, case maintenance, and high-volume customer interaction.

Job Responsibilities:

Provide enrollment assistance and HIPP/Premium Assistance program information over the phone to Medicaid eligible recipients and their family members. Verify, document, and investigate the presence of health care coverage for Medicaid recipients and their families. Assist in the identification of members that may qualify for the HIPP/Premium Assistance program. Complete periodic reports. Customer service to include high volume of phone work answering questions and other inquiries regarding the HIPP/Premium Assistance program. Data entry includes accurate and timely entry of information. Obtain and/or verify all items related to eligibility and enrollment into the HIPP/Premium Assistance program. Complete maintenance of active cases during open enrollment and premium review for check processing to assist with maintaining the revenue and program growth.

Skills:

Insurance verification, health insurance, Medicaid verification, Customer service, and HIPP / Premium Assistance Program.

Education/Experience:

High School Diploma or equivalent required Min. 2 years of experience in insurance industry, health care or government sponsored health insurance to include customer service and medical billing knowledge or similar math related experience. Min. 2-year experience working on the phone, making inquiries (outbound) and answering calls (inbound). Call Center Experience Preferred Human Resources or Health Insurance Experience preferred Bilingual Preferred Knowledge of health care terminology is a plus.