Conduent State Healthcare, LLC

Provide telephone support for NJ Family Care beneficiaries, document enrollment requests, and maintain program knowledge. | High school diploma or GED, basic call center experience, ability to work with diverse populations, and pass background screening. | 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. Remote - Customer Service Representative Paid Training Equipment Provided Full-time with Full Benefits Pay is $16/hour which may be below your state's minimum wage. Please take this into consideration when applying. We are currently NOT hiring in the following geographies, including but not limited to: States: AK, CA, HI, MA, IL, MT & NY Metro Areas: MN – Minneapolis, IL – Chicago, NY – New York City, OR - Portland, MD - Montgomery County, WA - Seattle, Washington, DC Are you seeking an opportunity to make a real impact in a company that appreciates ideas and new ways of thinking? Training Monday-Friday 8:00 am-5:00 pm 5-6 weeks Shifts: Availability between the hours of 8:00 AM - 8:00 PM on Monday and Thursday and 8:00 AM - 5:00 PM on Tuesday, Wednesday, and Friday. Join the Conduent Customer Service Team Come join us and grow with a team of people who will challenge and inspire you to be the best! Working for you Enjoy a positive, employee-friendly culture while playing an important role in supporting our clients. $16.00 per hour pay rate (bi-weekly pay) Paid Training with Equipment provided. Full-time schedule (40 hrs. a week) Career Growth Opportunities PerkSpot- Employee discount program Full Benefit Options - From the start, our paid training program will teach you all the skills needed to allow you to become successful in your role. We also offer a full benefits package, so you’ll be able to thrive both personally and professionally. About the Role Act as initial point of contact for inquiries from potential and existing NJ Family Care beneficiaries and community-based organizations related to the NJ Family Care Program Provide one-to-one telephone contact with applicants, beneficiaries, and enrollees in customer service roles. Accurately document enrollment requests, status changes, complaints, and grievances Enter application and enrollment information into a web-based computer system for customers wishing to apply for the program over the telephone. Maintain technical and program policy proficiency in the NJ Family Care rules/guidelines and other related program policies. Provide clear, complete, accurate, and objective information based on a full understanding of program requirements. Requirements Basic understanding of a call center environment in a customer service role and quality monitoring processes. Ability to establish and maintain effective working relationships with applicants, beneficiaries, and co-workers. Ability to problem solve through analysis and ongoing feedback. Achieve results through knowledge, empathy, and commitment. Ability to work with people of diverse backgrounds. High School diploma or GED Background and drug screening required. Pay Transparency Laws in some locations require disclosure of compensation and/or benefits-related information. For this position, actual salaries will vary and may be above or below the range based on various factors including but not limited to location, experience, and performance. In addition to base pay, this position, based on business need, may be eligible for a bonus or incentive. In addition, Conduent provides a variety of benefits to employees including health insurance coverage, voluntary dental and vision programs, life and disability insurance, a retirement savings plan, paid holidays, and paid time off (PTO) or vacation and/or sick time. The estimated hourly rate for this role is $16.00/h #Remote44 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. For US applicants: People with disabilities who need a reasonable accommodation to apply for or compete for employment with Conduent may request such accommodation(s) by submitting their request through this form that must be downloaded: click here to access or download the form. Complete the form and then email it as an attachment to FTADAAA@conduent.com. You may also click here to access Conduent's ADAAA Accommodation Policy.

Review and manage medical benefit claims to ensure accuracy, compliance, and effective communication with healthcare providers and clients. | Minimum 2 years experience in medical claims review or healthcare administration with strong knowledge of medical terminology and proficiency in healthcare software. | Job Title: Medical Benefit Review Services Associate - Region 3 Company Overview: Conduent State Healthcare, LLC is a leading provider of healthcare solutions, partnering with Fortune 100 companies and government agencies to deliver mission-critical services. We are committed to creating exceptional outcomes for our clients and the millions of people who rely on our expertise and dedication. Role Overview: As a Medical Benefit Review Services Associate, you will play a vital role in reviewing and managing medical benefit claims to ensure accuracy and compliance. This position is essential in supporting healthcare operations and improving service delivery for our clients in Region 3. What You'll Do: - You will review medical benefit claims for accuracy and completeness. - You will analyze medical documentation to verify eligibility and coverage. - You will communicate with healthcare providers and clients to resolve discrepancies. - You will ensure compliance with regulatory and company policies. - You will maintain detailed records of claim reviews and decisions. - You will collaborate with team members to improve review processes. - You will assist in training new associates on review procedures. - You will contribute to quality assurance initiatives to enhance service delivery. What You Bring: - Minimum of 2 years experience in medical claims review or healthcare administration. - Strong knowledge of medical terminology and healthcare benefit plans. - Excellent analytical and problem-solving skills. - Proficient in using healthcare management software and Microsoft Office. - Effective communication skills, both written and verbal. - Ability to work independently and as part of a team. Bonus Points If You Have: - Experience with Medicaid or Medicare claims processing. - Certification in medical billing or coding. - Familiarity with regulatory compliance standards such as HIPAA. - Prior experience in a customer service role within healthcare. What We Offer: - We offer competitive salary and comprehensive benefits package. - We offer opportunities for professional growth and development. - We offer a supportive and inclusive work environment. - We offer flexible work schedules to promote work-life balance. - We offer employee wellness programs and resources. Ready to Apply? To join our team as a Medical Benefit Review Services Associate, please submit your resume and cover letter through our online application portal. We look forward to reviewing your application and exploring how you can contribute to our mission of delivering exceptional healthcare services.