Medicaid Insurance Specialist Remote

What are we looking for in our Medicaid Insurance Specialist Remote?

Pride Global/Russell Tobin is currently seeking Medicaid Insurance Specialist to support our client. This is an excellent opportunity to work with a dynamic team and gain valuable experience in the Healthcare industry. Potential to extend or convert for the right candidate. Apply today for consideration!

Position: Medicaid Insurance Specialist

Location: Remote

Contract: 12+ months with possible extension.

Pay rate: $26-28.00/hr on W2

Daily Responsibilities:

• Demonstrate understanding of applicable quality requirements/guidelines (e.g., escalation procedures, use of SMEs)
• Demonstrate and apply understanding of established quality concepts and principles.
• Adhere to established quality processes, procedures, requirements, and guidelines.
• Demonstrate understanding of specific workgroups.
• Demonstrate knowledge of procedural flows and processes
• Utilize applicable systems/tools to maintain and document quality metrics/outcomes.
• Document call quality/efficiency/effectiveness, using applicable metrics and tools.
• Review/analyze quality data/metrics/and report improvement opportunities.
• Identify and communicate call quality patterns/trends to applicable stakeholders to drive appropriate action and meet future business needs.
• Monitor audit reports/results and provide feedback as needed to drive/validate process effectiveness.
• Plan, prioritize, organize, and complete work to meet established objectives and deadlines.
• Review and monitoring of agent sales activities (seasonal); supporting agency compliance initiatives, specifically updated CMS (Medicare) requirements.
• Cross functional team overseeing multi-distribution, multi-carrier agents; roughly 25 team members with skills including sales support professionals, business & quality analysts, and auditors.

Required Qualifications:

• Associate degree (or higher)
• 1+ years of experience in quality assurance, monitoring/auditing or compliance, Medicare preferred.
• Experience with Microsoft Word (creating and editing documents), Microsoft Excel (general spreadsheet navigation) and Microsoft Outlook (email and calendar management)
• Experience working with multiple system platforms.
• 1+ years of experience in health insurance and knowledge of products and services
• 1+ years of experience working with CMS guidelines and compliance.

ABOUT US:

Russell Tobin is a leading minority-owned professional and technical recruitment and staffing advisory organization. We are comprised of specialized practices focusing on a variety of skill sets and industries. Having a depth and breadth of industry expertise, our subject matter experts are able to provide tailored and swift sourcing solutions to fulfill client hiring needs. In other words, we connect top talent with companies.

As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.

Russell Tobin offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), a 401(k)-retirement savings, life & disability insurance, an employee assistance program, identity theft protection, legal support, auto and home insurance, pet insurance, and employee discounts with some preferred vendors.

Rate/Salary: $26-28.00/hr