Your Daily Mission

As a Social Services Specialist in the Best Benefits service line, you will play a key role in helping members access Long-Term Care through in-home or community-based resources. Your responsibilities include coordinating appointments, referrals, and providing ongoing support and follow-up throughout the application process.

In this fast-paced environment, you will handle both outbound and inbound calls, use screening tools to assess eligibility, and guide qualified members step-by-step through the application and waiver process.

Who You Are

• 1+ years of experience working in a professional office & fast-paced environment
• 1+ year working in Customer Service Center
• At least one year of health care experience desired
• High School Diploma or GED equivalent
• Experience preferred in one of the following areas: Business, customer service, Social Services, work with diverse populations; case management
• Basic knowledge of Medicaid and Long Term Care
• Knowledge and comfort engaging individuals of diverse cultural and ethnic backgrounds
• Basic knowledge of issues and challenges faced by under served and vulnerable populations
• Proficient skills with MS Office and Windows operating system
• Phone system utilization
• Strong Literacy (grammar, spelling, math)

The Reality of the Role

• Contact individuals regularly and clarifies any and all gathered eligibility data for Long Term Care In Home or Community based resources
• Obtains verbal authorization to represent and assists with all necessary documentation/verifications
• Mails forms to members to process case appropriately
• Advise members and members of program time limitations and ensure deadlines are met
• Follows up with the appropriate government agency on status of application
• Overcomes objections to appropriately complete the application
• Leverages technology and account processing workflows; maintains data integrity with accurate and concise documentation in Centauri’s systems
• Foresee what needs to be done with all accounts and take appropriate action to secure eligibility until all methods are exhausted
• Schedules appointments with the external agencies
• Maintains positive professional relationship with members, agencies and clients
• Contact providers / assists with ensuring documentation is sent to the appropriate agency
• Communicates with members via phone, and clarifies the details of our services, properly sets expectations for process and communication to ensure member understanding.
• Follows established workflow for member follow-up contact to determine outcome and resolution of member application.
• Documents all member contact in Centauri Health Solutions database.
• Perform miscellaneous clerical tasks. Promptly takes and returns all calls. Answer questions regarding the waiver process. Completes other duties as assigned.
• Maintains positive professional relationships with members, agencies and clients throughout application process.
• Ensures member satisfaction through scheduled follow-up contact.
• Manage a high volume of outbound/inbound phone calls.
• Manages weekly scheduled queue shifts.