What are the responsibilities and job description for the Eligibility Interviewer II (NMRHCA #10101133) position at State of New Mexico?
Posting Details
NMRHCA was established in 1990 to provide health care coverage to retirees of state agencies and eligible participating public entities. Approximately 305 public entities including cities, counties, universities and charter schools participate in NMRHCA. The agency provides medical plans for both non-Medicare and Medicare-eligible retirees and their dependents as well as dental, vision and life insurance. The Authority currently provides coverage to approximately 66,000 retirees and their dependents. The Authority is governed by an 11-member Board of Directors.
Interviews are anticipated to be conducted within two weeks of closing date.
Why does the job exist?
This position provides a broad range of customer service activities including but not limited to: greeting customers upon arrival, answering phone calls, determining their needs and responding to their questions. This position is responsible for reviewing and explaining benefits, program guidelines and eligibility rules, verifying service credit, processing payments, processing enrollment applications, assembling enrollment packets, opening and distributing mail and other general office correspondence. Plus, reconcile billing and eligibility discrepancies with health care partners while maintaining strict confidentiality at all times within accordance of Health Insurance Portability and Accountability Act (HIPAA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Assist and support other team members with other duties as needed to maintain agency services. Help with switch enrollment meetings and health fairs when required by handing out information and answering questions.
How does it get done?
Position provides direct customer service by telephone, email and person-to-person with agency participants and health plan partners to determine enrollment while adhering to health plan rules and regulations. The selected candidate will be required to develop knowledge of health care offerings and Medicare programs to communicate reliable and accurate information by attending trainings and learning benefit plans and rules. Some in state travel may be required.
Who are the customers?
Customers include:
Customers include:
High School diploma or Equivalent and/or one (1) year experience in customer service, office administration, government assistance programs such as welfare, unemployment benefits, social security benefits, and/or public housing. Any combination of education from an accredited college or university in a related field and/or direct experience in this occupation totaling one (1) year may substitute for the required experience.
Employment Requirements
Must possess and maintain a valid driver's license.
Working Conditions
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage. Some sitting, standing, bending and reaching may be required. Direct client interaction and some travel may be required.
Supplemental Information
Do you know what Total Compensation is? Click here
Agency Contact Information: Jessica Trujillo, (505) 372-9518 Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is not covered by a collective bargaining agreement.
NMRHCA was established in 1990 to provide health care coverage to retirees of state agencies and eligible participating public entities. Approximately 305 public entities including cities, counties, universities and charter schools participate in NMRHCA. The agency provides medical plans for both non-Medicare and Medicare-eligible retirees and their dependents as well as dental, vision and life insurance. The Authority currently provides coverage to approximately 66,000 retirees and their dependents. The Authority is governed by an 11-member Board of Directors.
Interviews are anticipated to be conducted within two weeks of closing date.
Why does the job exist?
This position provides a broad range of customer service activities including but not limited to: greeting customers upon arrival, answering phone calls, determining their needs and responding to their questions. This position is responsible for reviewing and explaining benefits, program guidelines and eligibility rules, verifying service credit, processing payments, processing enrollment applications, assembling enrollment packets, opening and distributing mail and other general office correspondence. Plus, reconcile billing and eligibility discrepancies with health care partners while maintaining strict confidentiality at all times within accordance of Health Insurance Portability and Accountability Act (HIPAA) and Centers for Medicare and Medicaid Services (CMS) guidelines. Assist and support other team members with other duties as needed to maintain agency services. Help with switch enrollment meetings and health fairs when required by handing out information and answering questions.
How does it get done?
Position provides direct customer service by telephone, email and person-to-person with agency participants and health plan partners to determine enrollment while adhering to health plan rules and regulations. The selected candidate will be required to develop knowledge of health care offerings and Medicare programs to communicate reliable and accurate information by attending trainings and learning benefit plans and rules. Some in state travel may be required.
Who are the customers?
Customers include:
- Eligible retirees
- State, Municipal and public organizations
- Employer/employee entities
Customers include:
- Eligible retirees
- State, Municipal and public organizations
- Employer/employee entities
High School diploma or Equivalent and/or one (1) year experience in customer service, office administration, government assistance programs such as welfare, unemployment benefits, social security benefits, and/or public housing. Any combination of education from an accredited college or university in a related field and/or direct experience in this occupation totaling one (1) year may substitute for the required experience.
Employment Requirements
Must possess and maintain a valid driver's license.
Working Conditions
Work is performed in an office setting with exposure to Visual/Video Display Terminal (VDT) and extensive personal computer and phone usage. Some sitting, standing, bending and reaching may be required. Direct client interaction and some travel may be required.
Supplemental Information
Do you know what Total Compensation is? Click here
Agency Contact Information: Jessica Trujillo, (505) 372-9518 Email
For information on Statutory Requirements for this position, click the Classification Description link on the job advertisement.
Bargaining Unit Position
This position is not covered by a collective bargaining agreement.
