Operations Specialist

CareSource

. Support Care Management and Member Services through clerical, administrative, customer service, and coordination activities .

Posted 11/6/2026full-timeBrooklyn • New York • United StatesMid-LevelSenior💰 $41,200 - $66,000 per yearWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates proficiency in customer service and administrative support within a healthcare environment, ensuring compliance with HIPAA and regulatory standards while effectively managing member interactions and care coordination.

Highest-signal resume keywords

Bilingual (Spanish, Russian, Chinese)Knowledge of Medicare and Medicaid RegulationsMicrosoft Office ProficiencyExcellent Verbal and Written Communication SkillsAttention to Detail

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Service Intake ProcessingAuthorization ProcessingMedical Billing TerminologyCare Plan SupportDocument Verification

Soft Skills

Conflict ResolutionProfessional Phone EtiquetteAdaptabilityCritical ThinkingMultitasking

Industry Keywords

HIPAA ComplianceHealthcare EnvironmentMember ServicesGeriatric CareCustomer Service

About the role

Key responsibilities & impact

Support Care Management and Member Services through clerical, administrative, customer service, and coordination activities
Support provision of care plans by ordering member services, equipment, supplies, transportation, and personal care
Process service intake from members and assist Nurse Care Managers with member interactions
Process authorizations
Answer incoming calls and make outgoing calls as requested
Review member care management survey results and identify issues requiring follow-up
Order services and supplies, ensuring timely delivery
Provide backup support to Member Services Representatives, including inbound and outbound calls
Create a welcoming environment for patients, visitors, and customers
Acknowledge customer requests and concerns and respond in a timely manner
Work closely with the Clinical Team
Verify documents appropriately
Adhere to HIPAA and state requirements and regulations
Perform other related duties as requested

Requirements

What you’ll need

High School or GED required
Bilingual (fluent in Spanish, Russian or Chinese) required
Fluency (speaking, reading, and writing) in multiple languages as determined by needs of business is required
Knowledge of Medicare and Medicaid regulations
Ability to utilize Microsoft Office Products
Knowledge of all federal, state, local and regulatory agency requirements as related to the department and position
Ability to integrate age specific requirements with individual developmental, mental, social and cultural needs when performing procedures for geriatric members
Excellent verbal and written communication skills
Ability to handle conflicts in a professional manner
Professional phone etiquette
Proper use of grammar
Ability to work in a fast paced environment
Adaptable to a constantly changing environment
Attention to detail
Ability to multitask
Ability to work independently and with a team
Critical thinking and listening skills
Decision making and problem solving skills
Familiarity with the healthcare environment (Medicaid/Medicare) preferred
Previous Medical billing/terminology experience preferred
Prior field experience working with therapists/other licensed medical professionals preferred
Licensure and Certification: None

Benefits

Comp & perks

Potential bonus tied to company and individual performance
Substantial and comprehensive total rewards package
Equal opportunity workplace fostering belonging and supporting individuals of all backgrounds