Office Service Clerk - Call Center - Goodwill : Job Details

JOB SUMMARY:

This position acts as a telephone triage agent for various 800 hotlines within the HealthChoice and Acute Care Administration divisions, providing customer service and resolving concerns for recipients and providers across Medicaid programs, including but not limited to HealthChoice, Medicaid, Maryland Children's Health Program (MCHP), and Family Planning. All inquiries and complaints are documented in the Provider Recipient Ombudsman Management Information System (PROMIS). The role also involves educating recipients and providers about navigating the Medicaid system, referencing relevant regulations, policies, and procedures. The agent triages medical complaints from recipients and providers, documenting issues in PROMIS, and refers complex cases to the Complaint Resolution Unit within the Division of Outreach and Care Coordination.

ESSENTIAL DUTIES & RESPONSIBILITIES:

• Answer incoming calls according to MMA policies and procedures, responding to client inquiries.
• Prepare and send client letters, including copying and mailing as necessary.
• Scan, file, and document all correspondence, letters, and documents.
• Process incoming mail: opening, stamping, indexing, and distributing to appropriate personnel.
• Respond to phone messages, update system files, and handle claims review correspondence.
• Respond to email inquiries following MMA policies.
• Provide clerical support such as photocopying, scanning, mailing, case closures, system updates, and assisting with special tasks.

EDUCATION AND/OR EXPERIENCE:

• High School diploma or equivalent preferred.
• Basic Math skills.

CERTIFICATES, LICENSES, REGISTRATIONS:

• None required.

QUALIFICATION REQUIREMENTS:

Must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made for individuals with disabilities.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Experience working in an office setting.
• Ability to perform repetitive motions for extended periods.

PHYSICAL REQUIREMENTS:

Must be able to lift up to 35 lbs., sit for long periods, walk, reach, and communicate verbally and audibly.

WORK ENVIRONMENT:

Moderate noise level.

EOE/MFDV

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