Job description:
Duties and Responsibilities include but are not limited to:
● Provide exceptional, patient-centered service with professionalism, empathy, and cultural sensitivity.
● Serve as the primary point of contact for patients requiring NYIA (New York Independent Assessor) evaluations for home care services.
● Educate and guide patients and caregivers through the NYIA assessment process, including required documentation and appointment expectations.
● Schedule, confirm, and prepare patients for NYIA assessments (both virtual and in-person), ensuring all prerequisites are completed and follow up with appeals when needed.
● Proactively follow up with patients to ensure readiness for assessment, including technology checks for virtual visits when applicable.
● Assist patients with ePACES transactions, including code removal and updates, to ensure eligibility alignment and prevent delays in NYIA assessments and MLTC enrollment.
● Coordinate with Medicaid, MLTC plans, and relevant entities to resolve eligibility or restriction code issues in a timely manner.
● Assist patients with Managed Long-Term Care (MLTC) enrollment following NYIA eligibility determinations.
● Communicate effectively with NYIA, MLTC plans, healthcare providers, and internal teams to coordinate care and ensure timely case progression.
● Manage high-volume inbound and outbound calls, emails, and messages with patients, caregivers, and insurance representatives.
● Verify insurance eligibility and benefits (Medicare, Medicaid, MLTC) via portals and direct communication.
● Track and monitor NYIA assessment status, MLTC enrollment progress, and related referrals through completion.
● Accurately enter, update, and maintain patient records, case notes, and documentation in internal systems.
● Identify and escalate barriers (e.g., eligibility issues, missing documentation, code restrictions) that may delay assessment or service initiation.
● Build and maintain strong relationships with community partners and referral sources.
● Ensure strict compliance with HIPAA, Medicaid regulations, and agency policies at all times.
Qualifications and Requirements
● Fluent in English and Mandarin (Required); Cantonese (Preferred).
● Strong understanding of NYIA assessment process, MLTC enrollment, Medicaid eligibility, and ePACES functions preferred.
● Experience handling Medicaid restriction/code removal processes strongly preferred.
● Excellent communication, customer service, and interpersonal skills with a patient-focused approach.
● Highly organized, detail-oriented, and able to manage multiple cases and priorities simultaneously.
● Comfortable handling high call volumes and time-sensitive follow-ups.
● Proficient in Microsoft Office and Adobe Acrobat/PDF editing.
● Experience with ePACES, Maximus/NYIA systems, or MLTC workflows preferred.
● Familiarity with HHA Exchange or similar healthcare systems preferred.
● Ability to quickly learn new systems and adapt to evolving processes.
● Minimum 1+ year experience in intake coordination, healthcare coordination, or customer service role preferred.
● High school diploma or higher required.
Language Requirements
● English (Required)
● Mandarin (Required)
● Cantonese (Preferred)
Benefits:
- 401(k)
- Gym membership
- Health insurance
- Paid sick time
- Paid time off
Work Location: In person