Patient service representative jobs in Bayonne, NJ - 1,760 jobs

Job Title: Senior Patient Registrar Assignment Duration: 24 weeks Shift: Monday-Friday, 9:00 AM - 5:00 PM Break: 45-minute unpaid break Pay Rate: $28/hour Job Summary The Senior Patient Registrar is responsible for patient registration, demographic and insurance verification, and providing excellent customer service in a fast-paced healthcare environment. This role requires strong clerical, data entry, and communication skills, with a preference for experience in a cardiology or medical office setting. Required Qualifications (R) High School Diploma or GED Minimum 3 years of clerical experience in a healthcare or administrative setting Data entry speed of 4,500 keystrokes per hour Strong customer service skills Excellent verbal and written communication skills Proficiency in telephone systems, keyboarding, and basic computer applications Knowledge of health insurance benefits and requirements Ability to work independently and as part of a team Preferred Qualifications (P) Some college coursework 3-5 years of experience in a cardiology, medical, or secretarial setting Strong proficiency with Electronic Health Records (EHR) systems Knowledge of medical coding, including ICD-9 and CPT-4 Prior customer service experience in a healthcare environment Pride Health offers eligible employee's comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors

Answer incoming calls and electronic requests from patients, family members, and external parties in a professional and courteous manner. Register new patients and schedule healthcare appointments while ensuring timely, accurate, and compliant data entry. Verify insurance coverage or determine patient self-pay responsibilities and provide cost estimates. Handle clerical and clinical messages from patients, family members, and healthcare professionals. Identify urgent patient situations and coordinate immediate triage. Remain composed with upset callers, escalating priority issues when needed.

Hours: Full Time 10:00 AM - 6:00 PM: Sunday 11:30 AM-7:30 PM: Monday-Thursday Premium Health is looking for outstanding candidates for the Patient Care Coordinator position for our Internal Medicine Department. Premium Health, located in the heart of Brooklyn, is committed to providing compassionate, culturally sensitive, comprehensive health care, and behavioral health services to everyone in the community in need, regardless of ability to pay. Through our services, we aim to achieve community wellness for the individuals and families we serve. Premium Health prioritizes a collaborative care approach and utilizes evidence-based treatment, thus achieving improved patient care and superior outcomes. Conveniently located midway between Flatbush and Boro Park, our Foster Avenue location is home to our adult internal medicine, adult behavioral health, and podiatry departments. Our team goes the extra mile to make every patient visit a positive one. In addition to providing top notch medical care, every visit is an opportunity to build relationships and every patient is treated like family. Our goal is to make each patient's care experience to our standards: Compassionate, Agile, Respectful, and Excellent. Ideal candidates will have prior experience working in a medical office and have familiarity in medical terminology. Time Commitment: 10:00 AM - 6:00 PM: Sunday 11:30 AM-7:30 PM: Monday-Thursday Responsibilities: Daily responsibilities include: · Document results reviewed with provider and convey them to the patient · Reply to patient medical questions as instructed by the provider · Refill medications · Complete medical forms · Assist providers with tasks as needed · Perform tasks as assigned by supervisor Compensation: $23-$25 an hour Benefits: Public Service Loan Forgiveness (PSLF) Paid Time Off, Medical, Dental and Vision plans, Retirement plans

Title: Customer Service Representative Duration: 4 month contract The Customer Service Representative (CSR) will be responsible for contacting students who have been accepted into our charter school program and assisting them with the onboarding process for the new school year. This role requires excellent communication skills, attention to detail, and a commitment to providing exceptional service to our students and their families. Key Responsibilities: * Contact newly accepted students and their families to welcome them to the program. * Provide detailed information about the onboarding process, including required documentation, important dates, and next steps. * Answer any questions students and families may have about the program and the school. * Assist with the completion and submission of necessary forms and paperwork. * Coordinate with other departments to ensure a smooth onboarding experience. * Maintain accurate records of all communications and interactions with students and families. * Follow up with students and families to ensure all onboarding requirements are met. * Address any concerns or issues that arise during the onboarding process in a timely and professional manner. Required Skills & Experience * High school diploma or equivalent; associate's or bachelor's degree preferred. * Previous experience in customer service, preferably in an educational setting. * Excellent verbal and written communication skills. * Strong organizational and time management skills. * Ability to work independently and as part of a team. * Proficiency in Microsoft Office Suite and other relevant software. * Bilingual skills are a plus.

About Us For more than 100 years, Strategic Insurance Partners (SIP) has been providing Personal and Business Insurance protection that fit your needs. Developing a comprehensive insurance portfolio can be a challenge without guidance from a trusted advisor. At Strategic Insurance Partners, we've been working alongside business owners in New York, New Jersey, and Pennsylvania for more than a century. Instituting extensive insurance expertise, SIP agents take a consultative approach toward identifying risks and proactively reducing the impact of loss through customized coverage. Our management and representatives have developed an atmosphere of trust over the years, which has enabled deeply valued and longstanding relationships with our clients. Commercial Lines Customer Service Representative Responsibilities: Policy Servicing: Assist the Account Managers with processing Change Requests, Audits, Certificates, and more. Agency Management System Operation: Work daily in AMS to access policy details and update the accounts for accuracy. Task Management: Track, follow up and close out service tasks. Team Collaboration: Partner with Account Managers and/or Account Executives to assist and maintain the retention lists every month, 90 days in advance. Customer Servicing: Assist the Account Managers with incoming calls when needed. Qualifications: Valid New Jersey Property and Casualty License required Minimum of 2 years of commercial lines insurance experience Knowledge of insurance products Proficiency with AMS360 and ImageRight preferred; experience with other agency management systems will be considered Effective verbal and written communication skills Excellent organizational skills Strong multitasking skills, attention to detail, and follow-through discipline Hours: Monday-Friday, 9:00am-5:00pm Office Location: 492 Franklin Avenue, Nutley, NJ 07110 Benefits: Competitive Salary Health Insurance Plans (PPO, HSA, Copay Options) Dental Insurance Vision Insurance Company Paid Disability Insurance Supplemental Insurance including Critical Illness, Accident, Legal, Pet Insurance 401(k) with Safe Harbor Match Paid Time Off Paid Holidays No Solicitation Notification to Agencies: Please note that Keystone Agency Partners and our Partner Agencies do not accept unsolicited resumes or calls from third-party recruiters or employment agencies. In the absence of a signed Master Service Agreement and approval from HR to submit resumes for a specific requisition, Keystone Agency Partners will not consider or approve payment to any third parties for hires made.

We are seeking a reliable Customer Service Representative to assist customers by providing product and service information, resolving issues, and ensuring a positive customer experience. The ideal candidate is a strong communicator who enjoys helping others and can handle inquiries with patience and professionalism. Key Responsibilities Respond to customer inquiries via phone, email, or chat Resolve customer complaints and issues in a timely and effective manner Provide accurate information about products, services, and policies Process orders, returns, exchanges, or account updates Document customer interactions and maintain accurate records Escalate complex issues to the appropriate team when necessary Maintain a positive, professional attitude at all times Qualifications Previous customer service experience preferred but not required Strong verbal and written communication skills

Russell Tobin's client is hiring a Customer Service Representative in Port Washington, NY Employment Type: Contract Pay rate: English Speaker - $17.50 French Speaker - $20 Responsibilities: Answer incoming calls and process customer orders. Troubleshoot technical issues, particularly related to electrical and IT systems, and communicate solutions clearly. Resolve customer complaints while maintaining composure and professionalism. Document customer interactions accurately and track call types. Follow up with customers regarding order status, shipping, and stock availability. Maintain support service levels consistent with Luxottica's standards. Perform all other duties as assigned. Requirements: High school diploma or equivalent. Minimum 1 year of experience in customer service, hospitality, or call center environments. Excellent telephone etiquette and communication skills (verbal and written). Strong PC skills including Microsoft Office (Word, Excel) and internet navigation. Ability to prioritize tasks, manage time efficiently, and work well in a team environment. Demonstrated listening and comprehension skills. Nice to have: Higher education degree. Experience using SAP. Knowledge of optical products and industry terminology. Bilingual in French. Benefits that Russell Tobin offers: 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.

Are you an experienced Credentialing Specialist with a desire to excel? If so, then Talent Software Services may have the job for you! Our client is seeking an experienced Credentialing Specialist to work at their office in Morristown, NJ. Primary Responsibilities/Accountabilities: Enforce regulatory compliance and quality assurance Prepare and maintain reports of credentialing activities such as accreditation, membership or facility privileges Ensure that all information meets legal, federal and state guidelines when processing applications Responsible for carrying out various credentialing processes in relation to physicians and allied health practitioners Process applications for initial applicants as well as reappointments (approximately 125-200 quarterly) Collect and process significant amounts of verification and accreditation information Maintain and update accurate information in the Echo database (includes education, training, experience, licensure) Prepare material for the Credentials Committee meeting, MEC as well as the Board of Trustees meeting Sets up and maintains provider information in Echo Maintains confidentiality of provider information Ensure compliance with the Bylaws at each location as it pertains to the credentialing process Schedule, and on occasion, attend and take minutes for site-based medical staff department meetings Process and collect dues for the site-based medical staff Compiles and maintains current and accurate data for all providers Sets up and maintains provider information in online credentialing database Tracks license and certification expirations for all providers Maintains confidentiality of provider information All other duties as assigned Qualifications: Knowledge of the credentialing process is required Ability to organize and prioritize work and manage multiple priorities Excellent verbal and written communication skills Ability to research and analyze data Ability to work independently Ability to establish and maintain effective working relationships Excellent computer skills

The Biller is responsible to bill all insurance companies, workers compensation carriers, as well as HMO/PPO carriers. Audits patient accounts to ensure procedures and charges are coded accurate and corrects billing errors. Able to identify stop loss claims, implants and missing codes. Maintains proficiency in Medical Terminology. The Biller is responsible for the follow-up performed on insurance balances as needed to ensure payment without delay is received from the insurance companies. Communicates clearly and efficiently by phone and in person with our clients and staff members. Maintains productivity standards and reports. Obtains updated demographic information and all necessary information needed to comply with insurance billing requirements. Operates computer to input follow up notes and retrieve collection and patient information. Is able to write effective appeals to insurance companies. Education and Work Experience 1. Knowledge of multiple insurance billing requirements and 1-2 years of billing experience 2. Knowledge of CPT, HCPCS, and Revenue Code structures 3. Effective written and verbal communication skills 4. Ability to multi-task, prioritize needs to meet required timelines 5. Analytical and problem-solving skills 6. High School Graduate or GED Equivalent Required

Job Title: Credentialing Specialist - Summit, NJ (ONSITE ROLE) NO REMOTE Hours: 37.5 hours/week (8:00 AM - 4:00 PM, Monday-Friday) Duration : 13 Weeks MUST HAVE PROVIDER CREDENTIALING EXP. Purpose: To confirm a clinician is qualified, Requirements: 2+ years of credentialing experience (medical staff office or hospital setting preferred). Strong knowledge of regulatory standards and credentialing best practices. Excellent written/verbal communication and organizational skills. Proficient in Microsoft Office and Echo or similar credentialing systems. Ability to manage multiple tasks independently and meet deadlines Duties :- Verification of Credentials Confirm that healthcare providers (e.g., physicians, nurses, therapists) have valid and current licenses, certifications, education, and training. Verify board certifications, malpractice history, and work experience. . Compliance and Regulatory Oversight Ensure all providers meet the requirements of regulatory agencies, hospitals, and insurance networks. Maintain compliance with standards from organizations such as The Joint Commission (TJC) or NCQA. . Enrollment and Privileging Manage applications for providers to be enrolled with insurance payers (so they can bill for services). Handle the hospital privileging process, which authorizes providers to perform specific procedures within a facility. Record Maintenance Maintain accurate and up-to-date credential files for each provider. Track expiration dates for licenses, certifications, and re-credentialing timelines . Communication and Coordination Act as a liaison between providers, HR, medical staff offices, and payers. Communicate with state licensing

Experienced Medical Receptionist - Front Desk, Mineola, Long Island. For Premier Private Ophthalmology Office in Mineola, Long Island (11501), adjacent to Long Island Railroad, Mineola Station and NYU Winthrop University Hospital with affiliated practice in the NYC, East Village (close to Stuyvesant Town / Union Square/ less than 1 block to L train), Both offices are beautiful, newly renovated with a positive vibe and teaching environment. This is a great opportunity to join a well-established, growing ophthalmology practice. Experience with insurance eligibility, understanding of billing and credentialing a must. Ophthalmology and Eye Care experience preferred. Competitive starting salary and benefits package come with this part-time (possible future full-time) opportunity. If you are interested, please forward your resume to: ************************ and ***************************. Applicant must be friendly, energetic, highly organized, and dependable with excellent customer service, computer and administrative skills. The ability to effectively and professionally communicate with patients, co-workers, managers and physicians is critical. Candidates must be able to maintain a professional image in appearance as well as over the phone. Providing courteous and friendly service to all patients while contributing to building a positive work environment is key! ***Ideal candidate is someone who can work (2-4 days/wk) in both offices (Long Island and NYC). Days and times needed include Mon., Tues., Wed., and Fridays with Fridays a priority. Typical shift would be 8:00/9:00AM to 4:00/6:00PM Job Responsibilities include: • Greet patients, patient registration, telephone coverage and appointment scheduling *Multi-task • Ensure patient information is accurate including billing information • Check patient eligibility and be familiar with in NY insurance carriers including commercial, governmental, Medicare, Medicaid, HMO, etc. • Answer insurance and collection calls from patients, call insurance companies to verify coverage or receipt of claims, call insurance companies to pre-certify procedures • Inform patients of medical office procedures and policies • Maintain and manage patient records • Move patients through appointments as scheduled • Collect co-pays and payments • Obtain external medical reports as required by medical professionals • Complete other clerical duties as assigned • Ensure reception area is well maintained, neat, clean, and well stocked. • Safeguard patient privacy and confidentiality • Experience in the medical field and understanding of terminology is desirable. • Ability to work well in a team environment a must. • Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion. • Proficiency with reading, writing, and communicating in English. • Proficiency Problem-solving skills to research and resolve discrepancies. • Knowledge of medical terminology likely to be encountered in medical claim • Special projects when needed. • Great hospitality skills with patients is paramount

We are seeking a motivated and knowledgeable Commercial Insurance Specialist to join our business insurance team. This role is responsible for advising commercial clients on insurance products, quoting and binding policies, servicing accounts, and ensuring customer satisfaction. The ideal candidate has a strong understanding of P&C insurance products and thrives in a fast-paced, client-focused environment. Key Responsibilities: Develop and maintain relationships with commercial clients, ensuring their property and casualty insurance questions are answered. Provide quotes, online policy insurance policies, and process endorsements, renewals, and cancellations. Respond to client inquiries and follow up to ensure excellent customer service and retention. Stay current on products, underwriting guidelines, and regulatory requirements. Maintain accurate records in the CRM and agency management systems. Requirements: 2+ years of experience in commercial property and casualty insurance preferred. Active P&C insurance license is a bonus Strong phone skills Familiarity with small and mid-size business insurance products and rating tools. Strong communication and customer service skills. Ability to multitask, manage priorities, and meet deadlines. Ability to commute daily to our Woodcliff Lake, NJ office is required. This is an in-office position, Monday through Friday, from 8:30 AM to 5:30 PM. Business attire and a clean-shaven appearance are required each day. Preferred Qualifications: Experience working in an independent agency or with a direct writer. Bilingual abilities are a plus. Bachelor's degree or equivalent professional experience.

*Shareholder Services Representative - Call Center (Entry Level)* *Schedule:* In-office Monday-Friday (10:00am-6:00pm) + *Mandatory Remote Saturdays* (10:00am-4:00pm ET) *Hours:* 40+ hours/week during peak season *Position Overview* The Shareholder Services Representative is responsible for providing highquality customer service to registered shareholders through both inbound and outbound calls. Using a shareholder call list provided by the client, this individual will educate shareholders on corporate actions, voting options, and relevant proposals, while ensuring all communications are logged accurately and professionally. This role operates in a *fastpaced call center environment*, with an expectation of completing *20-25 outbound calls per hour*. Representatives must be proactive, articulate, and able to multitask while delivering a superior customer experience. *Key Responsibilities* * Make outbound calls to shareholders using clientprovided call lists. * Provide customer service support to registered shareholders via inbound and outbound calls. * Educate shareholders on corporate actions, board proposals, and voting options. * Track, monitor, and report outstanding issues to ensure timely client updates. * Accurately log all call details and interactions into the Access Database. * Assist in the development of campaign themes and messaging to maintain a clear and effective narrative. * Maintain performance metrics in a highvolume call center environment. * Use only the company's tollfree 800 number for all calls (personal phone numbers never appear on caller ID). *Required Skills & Qualifications* * Customer service oriented with strong communication and interpersonal skills. * Ability to multitask effectively between inbound and outbound calls. * Selfmotivated, proactive, and able to stay productive during slower call periods. * Experience or education in *finance, business, or accounting* (required). * Strong professionalism-*zero tolerance for lateness*. * Must be available to work *every Saturday* (10:00am-4:00pm ET). *Experience Level* * *Entry Level*, with related coursework or professional exposure to finance, accounting, or business. *Preferred Skills* * Customer service * Finance or business management * Highvolume inbound/outbound calling * Strong clarity in verbal communication * Ability to meet or exceed call metrics *Disqualifiers* * No relevant experience or education in finance, accounting, or business. * Habitual lateness or reliability concerns. * Degrees unrelated to business/finance (Graphic Design, Fashion, Cosmetology, etc.) *without relevant work experience*. *Job Type & Location* This is a Contract position based out of New York, NY. *Pay and Benefits*The pay range for this position is $18.00 - $18.00/hr. Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: * Medical, dental & vision * Critical Illness, Accident, and Hospital * 401(k) Retirement Plan - Pre-tax and Roth post-tax contributions available * Life Insurance (Voluntary Life & AD&D for the employee and dependents) * Short and long-term disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) *Workplace Type*This is a fully onsite position in New York,NY. *Application Deadline*This position is anticipated to close on Jan 28, 2026. h4>About TEKsystems: We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company. The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. About TEKsystems and TEKsystems Global Services We're a leading provider of business and technology services. We accelerate business transformation for our customers. Our expertise in strategy, design, execution and operations unlocks business value through a range of solutions. We're a team of 80,000 strong, working with over 6,000 customers, including 80% of the Fortune 500 across North America, Europe and Asia, who partner with us for our scale, full-stack capabilities and speed. We're strategic thinkers, hands-on collaborators, helping customers capitalize on change and master the momentum of technology. We're building tomorrow by delivering business outcomes and making positive impacts in our global communities. TEKsystems and TEKsystems Global Services are Allegis Group companies. Learn more at TEKsystems.com. The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx, a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health, which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi, the industry's leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we're rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit **************** Position Summary: The QA Pharmacist will use their state regulatory knowledge to perform routine auditing and monitoring processes to ensure quality, accuracy, and regulatory compliance of coverage requests and appeals. The QA Pharmacist will utilize a strong comprehension of regulatory requirements to ensure success in annual reporting, program audits, and ad hoc audits. Position Responsibilities: Complete monthly utilization management and appeals performance and process audits in alignment with applicable regulations, accreditation standards, and best practices. Create and maintain progress reports and audit results in accordance with regulatory/accreditation requirements and internal processes. Present audit results to leadership in a timely manner to address issues and ensure adherence to departmental procedures and regulatory/accreditation requirements (CMS, URAC, NCQA). Continuously review and remain informed of all regulatory/accreditation requirements and updates impacting the coverage request and appeals processes. Respond to inquiries from internal and external stakeholders regarding quality assurance processes, audit results, and compliance policies and procedures. Work independently and with team members as warranted by audit assignment. Assist in designing and implementing audit tools and programs, creating QA scorecards and guides in collaboration with all department stakeholders. Provide ongoing performance feedback, to team leads to ensure consistent performance. Assist management in identifying, evaluating, and mitigating operational, and compliance risks. Work in collaboration with operational leaders to identify training opportunities and recommend improvements to Work Instructions, Job Aids, and Policy and Procedures to improve performance. Minimum Qualifications: Active, unrestricted, pharmacist license required 2+ years of state regulatory and auditutilization management experienceat a PBM or health plan required Extensive knowledge of how to operationalize regulatory requirements Strong oral and written communication skills required Intermediate to advanced Microsoft Excel skills required Possess strong analytical skills, attention to detail, quantitative, and problem-solving abilities Ability to work independently with minimal supervision, stay productive in a remote, high-volume, metric driven work environment Ability to multi-task and collaborate in a team with shifting priorities Preferred Qualifications: Familiarity/experience with URAC and NCQA accreditation requirements Utilization management and/or appeals audit experience 3+ years of compliance or regulatory experience at a PBM or health plan This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. #LI-BC1 Salary Range$135,000-$145,000 USD All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals. Judi Health values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. By submitting an application, you agree to the retention of your personal data for consideration for a future position at Judi Health. More details about Judi Health's privacy practices can be found at*********************************************

Job Description * Serves as a liaison between doctor's offices, the hospital, and patients. * Schedules appointments for various hospital departments and physician office visits. * The scheduler receives routine functional guidance from the supervisor/manager of Patient Access concerning resources to make appropriate patient referrals. * Manual dexterity is required as is the ability to concentrate on detail in the midst of other activity. * The scheduler will follow very specific protocols in scheduling and the collection of financial information. * The scheduler assures that all patients have all information they need so that they will arrive on time and prepared for their procedures and the hospital has all the information required to properly bill or services. * Receives requests to schedule patients from referrals and schedules patients accordingly. * Maintains open communication with other departments regarding scheduling changes. * Properly verifies and obtain prior-authorization when needed. * Follows up on any requests and/or messages left on work phone immediately. * Coordinates transportation needs for patients appointments. EDUCATION + EXPERIENCE REQUIREMENTS: High school Diploma required. College Degree preferred. 2 or more years experience in hospital registration/patient access is desired. 2 or more years of hospital setting experience in scheduling is required. Must have type speed of at least 45 WPM and basic experience with main frame computers, calculators, copiers, FAX machines, and multi-line phone systems required Knowledge of medical terminology Must be through and able to follow detailed instructions Must have excellent customer service skills Ability to work with speed and accuracy while multi-tasking is required

TITLE: Entitlement Medicaid Specialist (FT) REPORTS TO: Director of Entitlements Our Mission: Since 1967, Odyssey House has been providing innovative services and programs to a broad population of individuals and families struggling with substance use and mental health disorders. Odyssey House helps New Yorkers of all ages-and across all five boroughs-beat drugs and alcohol with highly individualized treatment programs. Odyssey House provides high quality, holistic treatment impacting all major life spheres, including: psychological, physical, social, family, educational and spiritual in order to support personal rehabilitation, renewal and family restoration. If that sounds different than other treatment programs, you're right. Because Odyssey is where recovery gets real. In addition to competitive salaries, Odyssey House offers: A 35-hour work week (as opposed to a 40-hour work week) Vacation Plan and Holiday Schedule Life Insurance Medical Insurance (Two Plans) Dental and Vision Insurance Additional Insurance Coverages (hospitalization, accidental, critical illness coverage) Long-Term & Short-Term Disability Flexible Spending Account/Health Reimbursement Account 403(b) Plan Corporate Counseling Associates (CCA) EAP benefit Ability Assist Counseling Services (through The Hartford) Commuter Benefits Educational Assistance Programs Special shopping discounts through ADP Marketplace and PlumBenefits RUFit?! Fitness Program Legal Assistance through ARAG Optum Financial Service through ConnectYourCare Benefit Advocacy Center through Gallagher MAJOR FUNCTIONS: Maintain a working relationship with the Department of Social Service (DSS), Human Resources Administration (HRA), the Social Security Administration (SSA), Medicaid Office, Expedited and Marketplace to ensure Medicaid Managed Care guidelines, policies and procedures are followed to receive appropriate funding for 819 and 820 programs. SPECIFIC DUTIES & RESPONSIBILITIES: Conduct daily comprehensive review of consumers' interviews to determine eligible for Entitlements benefits, Medicaid Eligibility, Medicaid Managed Care, Medicare, Private Insurance coverage, Self-Pay Case conference difficult cases with the Director for guidance and support to ensure funding for 819 and Part 820 programs are obtained in a timely fashion Conduct interviews on new admissions for HRA/DSS/Medicaid/SSI/SSD/Self-Pay Expedite consumers with the selection of Managed Care Organization, assist with the NY State Market Place at point of admissions and upon Medicaid Eligibility Daily Data Entry of Medicaid Managed Care coverage / Medicare / Private Insurance / MAT in AWARDS, E-Lab and LabCorp Portal Daily update the Entitlement 820 Reports with consumers' coverage Navigate Epaces (eMedNY) / Inovalon / STARS / SAAMS / AWARDS / WTW / Manage Care System Portals for coverage Communicate with consumers regarding insurance coverage, restrictions, and disenrollment (Medicaid/Managed Care, Medicare, and Private Insurance) Process Medicaid applications and recertifications for consumers through the Department of Social Services, NY State Exchange/Marketplace Investigate Medicaid disparities related to county / deferral / eligibility / denial / dropped / recertification Identify and process consumers with Medical / Pharmacy / Out-Patient restrictions through the Managed Care Organization and Managed Care System (MCS) Resolve problematic Medicaid Managed Care issues for Part 820 coverage Complete and submit bi-weekly 820 Medicaid Managed Care Reports Complete weekly Medicaid Manage Care Reports for five residential programs to reflect consumers' coverage for the Pharmacy, Medical department and LabCorp Other relevant duties as assigned REQUIREMENTS: BA Degree preferred Experience with Medicaid Managed Care; Human Services Field Background with DSS/HRA benefits, Recertifications, Medicaid Managed Care, Expediting, enrollment and disenrollment Demonstrated effective communication, proficiency in Excel, computer skills, organization and multitasking Notary Public Stamp Odyssey House is an equal opportunity employer maintaining a non-discriminatory policy on hiring of its personnel. Odyssey House, and its operational divisions, will not discriminate against any employee or applicant because of race, creed, color, national origin, sex, disability, marital status, sexual orientation or citizen status in all employment decisions including but not limited to recruitment, hiring, upgrading, demotion, downgrading, transfer, training, rate of pay or other forms of compensation, layoff, termination and all other terms and conditions of employment.

Job Title : Customer Service Representative Duration : 2+ months contract (Possible extension ) Education : High school degree Shift Details : M-F schedule 9A-5P Job Description: • Assist all line of business (Medicaid/Medicare/MLTC/CHP/EP) in retaining current qualified members by following a strategic daily work schedule that includes am and pm hours, field locations as well as weekends. • Maintaining daily Outreach and Renewal goals set through business needs to increase overall retention Enrollment and retention support. • They are experts on the system and understand the NYSOH processes to quickly route members to the appropriate resolution and support. • The Customer Success Specialist will work as a liaison to ensure proper processes are introduced and implemented such that the experience is enhanced.

The Credentialing Specialist is responsible for coordinating and managing all aspects of provider credentialing and re-credentialing activities. This role ensures that all medical staff, allied health professionals, and other designated providers meet organizational, regulatory, and accreditation requirements prior to practicing. The position requires strong healthcare experience, exceptional attention to detail, and proficiency with credentialing systems. This is a fully onsite position. Key Responsibilities Credentialing & Re-Credentialing Facilitate the complete credentialing lifecycle for initial appointments, reappointments, and ongoing audits. Manage clinical privileging processes for medical staff and allied health professionals in accordance with policies, procedures, and bylaws. Primary Source Verification Perform and document primary source verification for new and existing providers. Ensure compliance with verification standards and due diligence requirements. License & Certification Management Track and ensure timely renewal of provider licenses and certifications prior to expiration. Update provider files and databases promptly as renewals are completed. Records Management & Data Integrity Maintain accurate, organized, and up-to-date provider credentialing files. Ensure consistency and accuracy in all credentialing database entries. Utilize software tools to monitor status alerts, run reports, and review scanned documentation. Compliance & Regulatory Standards Interpret and apply standards from accrediting and regulatory agencies. Maintain working knowledge of laws, statutes, and regulations related to credentialing. Software & Technology Use MDStaff credentialing software (or similar systems) for data entry, tracking, and monitoring credentialing activities. Team Support & Backup Coverage Provide credentialing support for other members of the credentialing team as needed to ensure continuity of operations. Minimum Required Skills & Qualifications Bachelor's Degree - Required. Healthcare Field Experience - Previous experience working within a healthcare environment is mandatory. Credentialing Expertise - Hands-on experience with provider credentialing and privileging. Primary Source Verification Skills - Ability to conduct and document all required verification activities. MDStaff or Equivalent Software Proficiency - Experience managing data within credentialing systems. Regulatory Knowledge - Understanding of accreditation and regulatory standards governing credentialing activities. Exceptional Attention to Detail - Ability to ensure accuracy, consistency, and data integrity. Records Management Skills - Experience maintaining comprehensive, compliant credentialing files. Backup Capability - Ability to step in for other credentialing team members when coverage is needed. Pride Health offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.

* Serves as a liaison between doctor's offices, the hospital, and patients. * Schedules appointments for various hospital departments and physician office visits. * The scheduler receives routine functional guidance from the supervisor/manager of Patient Access concerning resources to make appropriate patient referrals. * Manual dexterity is required as is the ability to concentrate on detail in the midst of other activity. * The scheduler will follow very specific protocols in scheduling and the collection of financial information. * The scheduler assures that all patients have all information they need so that they will arrive on time and prepared for their procedures and the hospital has all the information required to properly bill or services. * Receives requests to schedule patients from referrals and schedules patients accordingly. * Maintains open communication with other departments regarding scheduling changes. * Properly verifies and obtain prior-authorization when needed. * Follows up on any requests and/or messages left on work phone immediately. * Coordinates transportation needs for patients appointments. EDUCATION + EXPERIENCE REQUIREMENTS: High school Diploma required. College Degree preferred. 2 or more years experience in hospital registration/patient access is desired. 2 or more years of hospital setting experience in scheduling is required. Must have type speed of at least 45 WPM and basic experience with main frame computers, calculators, copiers, FAX machines, and multi-line phone systems required Knowledge of medical terminology Must be through and able to follow detailed instructions Must have excellent customer service skills Ability to work with speed and accuracy while multi-tasking is required