Job Overview
Location
Remote - NY
Job Type
Full-time
Category
Customer Support
Date Posted
May 17, 2026
Full Job Description
đź“‹ Description
- • Conduct telephonic outreaches to newly enrolled members to review current and approved services, durable medical equipment (DME), and additional service requests
- • Review intake documents for pre-approved services and escalate any discrepancies to case managers or primary care managers
- • Complete Welcome Onboarding and Consumer Directed Personal Assistant Assessments, identifying risk factors that require clinical escalation
- • Initiate, finalize, update, and discontinue service and DME authorizations within the Trucare system based on preapproved plans
- • Handle and accurately document inbound and outbound calls from members regarding benefit questions, appointment scheduling, assessment inquiries, service issues, and grievances
- • Communicate with healthcare providers to coordinate authorization initiation and updates, referrals, visits, tests, and faxed care plans
- • Educate members and providers on requirements for service approval and documentation standards
- • Manage a high-volume caseload while ensuring timely and accurate documentation of all member interactions and service needs
- • Monitor member screening processes to support improved quality and cost outcomes
- • Collaborate with inter- and intra-departmental teams to resolve onboarding issues and align service delivery
- • Handle member mailings and fax clinical requests and approved authorized service plans
- • Maintain accurate records in computer systems for all call documentation and service-related activities
- • Perform additional duties as assigned to support operational efficiency and member service goals
🎯 Requirements
- • High School diploma or GED equivalent
- • Experience in a customer service environment
- • Experience working in a fast-paced environment requiring handling of multiple priorities simultaneously
- • Work experience demonstrating effective verbal and written communication with strong grammar, spelling, and punctuation skills
- • Demonstrated ability to document calls into a computer system
🏖️ Benefits
- • Medical, dental, and vision coverage
- • Incentive and recognition programs
- • Life insurance
- • 401k contributions
- • Salary range of $34,900–$54,570 depending on location and qualifications
- • Competitive compensation and benefits package aligned with employee location
Skills & Technologies
About Healthfirst, Inc.
Healthfirst is a New York-based health insurance provider offering affordable, comprehensive plans to individuals, families, and seniors. For over 30 years, the company has delivered diverse options, including Essential Plans, Medicaid Managed Care, Child Health Plus, Marketplace plans, and specialized Medicare Advantage and Long-Term Care solutions. Healthfirst offers benefits like medical, prescription drug, dental, and vision coverage. Notably, Healthfirst maintains the only 5-star rated Essential Plan in New York for two consecutive years, solidifying its position as a trusted leader in accessible community healthcare.
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