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Transaction Processing Associate III

3 months ago

Chattanooga, Tennessee, United States Conduent State Healthcare, LLC Full time

Through our dedicated associates, Conduent delivers mission-critical services and solutions on behalf of Fortune 100 companies and over 500 governments - creating exceptional outcomes for our clients and the millions of people who count on them. You have an opportunity to personally thrive, make a difference and be part of a culture where individuality is noticed and valued every day.


Onsite: Hamilton, NJ

Payrate: $20.50

Fulltime with Full Benefits

Reports directly to the Eligibility Health Benefit Coordinator Supervisor. Processes eligibility application and determines eligibility for the NJ Family Care program and refers beneficiaries that are potentially eligible for Medicaid to DMAHS for review. Enters eligibility information into a web-based computer system and references other NJ-specific databases as appropriate. Follows up with beneficiaries with correspondence, performs file updates as information comes in, and assesses service/information.

Essential duties may include, but are not limited to:
- Review renewal information on the web-based system and associated imaged documents. Verify data displayed for the renewal is consistent with information on imaged documents.
- Identify missing information and initiate requests for generation of missing \information notices.
- Document missing information in the web-based computer system.
- Enter, review and processing missing information when documentation is received.
- Determine eligibility for NJ Family Care according to the NJ Family Care regulations/guidelines by reviewing documentation to accurately enter data into a web-based computer system and following procedures for running automated eligibility rules; prepare correspondence for missing information as appropriate; make outbound calls to obtain, clarify, or validate information
- Use scanned images of documents as source for data entry to process eligibility, renewal determination and status change information in a web-based computer system
- Verify information provided by beneficiaries and investigates discrepancies.
- Initiate telephone calls to beneficiaries to follow-up and confirm information, as necessary.
- Immediately report any technical problems with equipment, systems or facilities to the Eligibility Determination Supervisor.
- Refer beneficiaries potentially eligible for Medicaid to DMAHS using the functionality of the web-based computer system
- Route eligibility decisions to supervisors for review, as required by approved policies and procedures.
- Participate in and contribute to the quality improvement process
- Participate in training sessions.
- Perform enrollment services duties over the telephone during times of peak calls
- Conduct outbound calls to assist applicants and existing beneficiaries submit required information in a timely manner during peak period as needed
- Other duties as assigned.

Minimum Experience Requirements
- HS Diploma or greater associate's degree preferred
- Two years customer service experience in a healthcare field preferred
- Experience working with detailed data and following defined procedures.
- Experience in the determination of beneficiary eligibility for public assistance is desired

Required skills/abilities
- Knowledge of Medicaid and managed care programs.
- Demonstrated data entry accuracy and ability to enter data from scanned images
- Knowledge of available state and federal human service assistance programs and their eligibility requirements.
- Knowledge of the principles of interviewing and other information-gathering techniques.
- Ability to interpret and apply program policies and procedures as appropriate
- Ability to use basic arithmetic procedures in order to determine household size and income and determine program eligibility.
- Ability to establish and maintain effective working relationships with beneficiaries, co-workers and the community.
- Ability to apply logical reasoning in order to make timely, effective decisions.
- Ability to communicate complex information effectively.
- Ability to evaluate information received from or about beneficiaries for accuracy and completeness.
- Ability to maintain self-control under stressful situations.
- Ability to handle multiple tasks and meet deadlines; flexibility under pressure
- Ability to work with people of diverse backgrounds
- Ability to maintain strict confidentiality
- Capable of working independently
- Excellent verbal, written, and interpersonal skills
- Proficient in use of personal computer, including MS Office Suite
- Bilingual capabilities a plus

Conduent is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, creed, religion, ancestry, national origin, age, gender identity, gender expression, sex/gender, marital status, sexual orientation, physical or mental disability, medical condition, use of a guide dog or service animal, military/veteran status, citizenship status, basis of genetic information, or any other group protected by law.

People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by clicking on the following link, completing the accommodation request form, and submitting the request by using the "Submit" button at the bottom of the form. For those using Google Chrome or Mozilla Firefox please download the form first: click here to access or download the form. You may also click here to access Conduent's ADAAA Accommodation Policy.

At Conduent we value the health and safety of our associates, their families and our community. For US applicants while we DO NOT require vaccination for most of our jobs, we DO require that you provide us with your vaccination status, where legally permissible. Providing this information is a requirement of your employment at Conduent.