Top 191 Medicaid customer service representative Jobs in New York State

Representative, Health Plan Provider Relations - Remote Must reside in NY
Molina Healthcare —New York, NY
- $19.84 - $46.42 an hour
- Full-time
- Remote
- Medical office experience
- Mid-level
- Travel
- Health insurance
Speech Language Pathologist (SLP) or CFY Candidate
Rochester Childfirst Network —Rochester, NY
- $34 - $42 an hour
- Full-time
- Background check
- Microsoft Excel
- Microsoft Outlook
- Employee assistance program
Quick Apply
MAP Sales Representative II
MetroPlusHealth: Direct —New York, NY
- $65,592 a year
- Weekends as needed
- Addiction Medicine
- Mid-level
- Office
- Disability insurance
- Health insurance
3d
Aging Services Specialist - Case Mgmt
Tioga Opportunities, Inc. —Owego, NY
- $18.50 an hour
- Full-time
- Mid-level
- Microsoft Office
- High school diploma or GED
- Paid holidays
- Disability insurance
Quick Apply
8d
SOCIAL WORKER
CenterLight Health System —Queens, NY
- $85,280 - $102,960 a year
- Full-time
- Master of Social Work
- Skilled nursing facility
- OSHA
Provider Services Representative
MJHS —New York, NY
- $40,000 - $43,000 a year
- Full-time
- Remote
- Mid-level
- 3 years
- High school diploma or GED
- Health insurance
- Dental insurance
Call Center Representative
Help at Home —Brooklyn, NY
- $22 - $24 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Home Health
- Paid holidays
- Health insurance
2d
Customer Service Specialist II
General Dynamics Information Technology —Albany, NY
- $18.27 - $24.73 an hour
- Hybrid work
- Microsoft Excel
- Mid-level
- No travel
13d
PAYMENT PROCESSING SPECIALIST
HRA/DEPT OF SOCIAL SERVICES —Manhattan, NY
- $62,868 - $72,298 a year
- Full-time
- Writing skills
- Mid-level
- Office
- Loan forgiveness
- Food provided
Hospital Care Investigator
NYC Health + Hospitals —New York, NY
- $55,437 a year
- Online Application
- Microsoft Word
- Skilled nursing facility
- Psychiatry
- Commuter assistance
- Paid holidays
Hospital Care Investigator Provisional Appointment
NYC Health + Hospitals —New York, NY
- $55,437 a year
- Online Application
- Mid-level
- Office
- High school diploma or GED
- Commuter assistance
- Paid holidays
Patient Representative/Advocate
Garnet Health —Harris, NY
- $26.65 - $27.45 an hour
- Part-time
- Hybrid work
- Bilingual
- Hospital
- Customer service
- Health insurance
- Dental insurance
Patient Services Representative
RYAN-CHELSEA CLINTON COMMUNITY HEALTH CENTER —New York, NY
- $26.93 - $28.49 an hour
- Full-time
- Spanish
- Primary Care
- English
Quick Apply
Field Reimbursement Manager - Long Island, NY ( Includes, Brooklyn, Queens and Long Island)
Amgen —New York, NY
- $145,470.70 - $196,813.30 a year
- Hybrid work
- Clean driving record
- Doctoral degree
- Computer literacy
- Disability insurance
- Health insurance
Hospital Billing and Follow Up Representative
Jzanus Consulting —Garden City, NY
- From $55,000 a year
- Full-time
- Hybrid work
- Computer literacy
- HIPAA
- Research
- Health insurance
- Dental insurance
2d
Hospital Care Investigator (Provisional)
NYC Health + Hospitals —New York, NY
- $55,437 a year
- Online Application
- Hospital
- Mid-level
- Office
- Commuter assistance
- Paid holidays
Claims Service Representative
Centers Plan for Healthy Living —Staten Island, NY
- $19.49 - $23.08 an hour
- Full-time
- Mid-level
- High school diploma or GED
Quick Apply
Customer Service Representative II - Lowville, NY
Maximus —Lowville, NY
- $18.00 - $20.50 an hour
- Word processing
- Mid-level
- Office
- Paid holidays
- Disability insurance
5d
Registrar (Union)
Richmond University Medical Center —Staten Island, NY
- $24.72 - $26.03 an hour
- Day shift
- Hospital
- Word processing
- High school diploma or GED
Medicaid/CharityCare Eligibility Representative
Panacea Healthcare Solutions, LLC —Nyack, NY
- $20 - $25 an hour
- Full-time
- Spanish
- Hospital
- High school diploma or GED
- Health savings account
- Paid holidays
Quick Apply

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Representative, Health Plan Provider Relations - Remote Must reside in NY

Molina Healthcare -
New York, NY

Apply Now

Job Details

Full-time
$19.84 - $46.42 an hour

Benefits

Health insurance

Qualifications

Customer communication
Managed care
Managed care organization experience
Medical office experience
Schedule management
Health insurance knowledge
Productivity software
Cross-functional collaboration
Cross-functional communication

Full Job Description

JOB DESCRIPTION Job Summary

Provides support for health plan provider relations activities. Supports network development, network adequacy and provider training and education. Serves as primary point of contact between the business and contracted providers within the Molina network. Responsible for network management including provider education, communication, satisfaction, issue intake, access/availability and ensuring knowledge of and compliance with Molina policies and procedures.

Essential Job Duties

Successfully engages high-volume, high-visibility plan providers, to ensure provider satisfaction, facilitate education on key Molina initiatives, and improve coordination and partnership between the health plan and contracted providers.
Serves as the primary point of contact between Molina health plan and the non-complex provider community that services Molina members, including but not limited to fee-for-service (FFS) and pay-for-performance (P4P) providers.
Collaborates directly with the plan’s external providers to educate, advocate and engage as valuable partners - ensuring knowledge of and compliance with Molina policies and procedures while achieving the highest level of customer service; effectively drives timely issue resolution, electronic medical record (EMR) connectivity, and provider portal adoption.
Conducts regular provider site visits within assigned region/service area; determines daily or weekly schedule, to meet or exceed the plan's monthly site visit goals. Proactively engages with the provider and staff to determine; for example, non-compliance with Molina policies/procedures or Centers for Medicare and Medicaid Services (CMS) guidelines/regulations, or to assess the non-clinical quality of customer service provided to Molina members.
Provides on-the-spot training and education as needed, including counseling providers diplomatically, while retaining a positive working relationship.
Independently troubleshoots provider problems as they arise, and takes initiative in preventing and resolving issues between the provider and the plan whenever possible. The types of questions, issues or problems that may emerge during visits are unpredictable and may range from simple to very complex or sensitive matters.
Initiates, coordinates and participates in problem-solving meetings between the provider and Molina stakeholders, including senior leadership and physicians (examples include: issues related to utilization management, pharmacy, quality of care, and correct coding).
Independently delivers training and presentations to assigned providers and their staff - answering questions that come up on behalf of the health plan; may also deliver training and presentations to larger groups, such as leaders and management of provider offices, including large multispecialty groups or health systems, executive level decision makers, association meetings, and joint operating committees (JOCs).
Performs an integral role in network management, by monitoring and enforcing company policies and procedures, while increasing provider effectiveness by educating and promoting participation in various Molina initiatives; examples of such initiatives include: administrative cost-effectiveness, member satisfaction - Consumer Assessment of Healthcare Providers and Systems (CAHPS), regulatory-related, Molina quality programs, and taking advantage of electronic solutions (electronic data interchange (EDI), EMR, provider portal, provider website, etc.).
May provide training and support to new and existing provider relations team members as appropriate.

will require to travel at least once a week subject to change.

Required Qualifications

At least 2 years of customer service, provider services, or claims experience in a managed care or medical office setting, or equivalent combination of relevant education and experience.
General understanding of the health care delivery system, including government-sponsored health plans.
Organizational skills and attention to detail.
Ability to manage multiple tasks and deadlines effectively.
Interpersonal skills, including ability to interface with providers and medical office staff.
Ability to work in a cross-functional highly matrixed organization.
Effective verbal and written communication skills.
Microsoft Office suite and applicable software programs proficiency.

Preferred Qualifications

Familiarity with various managed health care provider compensation methodologies, primarily across Medicaid and Medicare lines of business, including: fee-for service (FFS), capitation and various forms of risk, ASO, etc.
Experience delivering training and facilitating educational presentations.

To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.

Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V

Pay Range: $19.84 - $46.42 / HOURLY
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.

Apply Now

Refine Your Search

medicaid customer service representative jobs in new york state

Representative, Health Plan Provider Relations - Remote Must reside in NY

Speech Language Pathologist (SLP) or CFY Candidate

MAP Sales Representative II

Aging Services Specialist - Case Mgmt

SOCIAL WORKER

Provider Services Representative

Call Center Representative

Customer Service Specialist II

PAYMENT PROCESSING SPECIALIST

Hospital Care Investigator

Hospital Care Investigator Provisional Appointment

Patient Representative/Advocate

Patient Services Representative

Field Reimbursement Manager - Long Island, NY ( Includes, Brooklyn, Queens and Long Island)

Hospital Billing and Follow Up Representative

Hospital Care Investigator (Provisional)

Claims Service Representative

Customer Service Representative II - Lowville, NY

Registrar (Union)

Medicaid/CharityCare Eligibility Representative

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