Customer Service Representative and eligibility worker

OREGON HEALTH AUTHORITY

HSS*

Salem, OR

Determine eligibility for OCCS Medical Programs and issue benefits to qualifying Oregonians.

Participated in UAT testing and tested our new ONE Eligibility System before it went live for staff or clients to use. Was able to test system and troubleshoot technical errors given in ONE Worker Portal and ONE Applicant Portal views that would be used by internal staff and external participants such as Community Partners and clients.

Communicated effectively with internal & external staff, clients, providers, and manage care plans through email, in writing, over the telephone and in person.

Provided written notices to notify applicants of approval, closure, or denial of benefits.

Use computer applications to help gather, compile, organize, research, and analyze reported information and data collected.

Work in special projects and identify potential project issues and presented alternatives.

Provided and performed lead work duties while supporting staff members with escalated calls and routine questions pertaining to our OCCS Medical Programs.

OREGON HEALTH AUTHORITIES

PSR3

Salem, OR

Through the use of a multi-line telephone, computer and mail I collaborate with clients, advocates, providers, managed care plans, outreach facilities, and agency staff regarding Medicaid programs.

Added newborns to medical cases and enroll them into a coordinating care organization.

Dealt with highly confidential information.

Prepare clear and concise narrative reports for permanent record.

Updated/ reported changes to client’s demographic information or address change and issued new medical ID cards.

Communicated with internal departments, such as DMAP Client Enrollment Services, to ensure clients were enrolled in their designated county Coordinated Care Organization (CCO).

Called out to clients who had chosen “oral presentation” as their preferred method to receive correspondence from our Agency.

Gather appointment detail information, location of surgery, and duration of stay in order to process a form which would determine if client was eligible to receive medical transportation, mileage reimbursement, or have meals and lodging fees covered; Forwarded completed forms to corresponding department for processing

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