Enrollment Specialist HH

Overview

Our growing Health Home Division is a "Virtual Home" for Medicaid recipients with chronic health conditions. It is a care management model where all individual caregivers communicate to address patient's needs in a comprehensive manner. Essen's health home division has a team of care coordinators who function as connectors and coordinators to a patient's care team and connect members to the social services they need, including housing, transportation to appointments, medication reminders, educational courses, financial support and more.

Job Summary

The Enrollment Specialist is responsible to perform various data entry functions. The incumbent must be able to process multiple members' enrollment documentations and updates into the lead health home's database. The process includes utilizing the lead health home referral processes, reviewing and auditing the enroll segments, and obtaining final approval to process the documents to enroll and bill.

Responsibilities

1. Researches, verifies, and processes patient enrollments as part of the lead health home providers regulatory requirements.
2. Contacts the outreach specialists to verify and obtain additional missing documents prior to submission to the lead health home electronic portal.
3. Communicates with the outreach team to walk them through the application and update process and requirements to upload the
4. Documents communication notes and resolution outcomes with lead health providers.
5. Assures lead health home compliance that all data sources though eCares and SharePoint are submitted in its entirety and confirm that all documents, including enrollments notes and consent forms are accurate and all revalidation documents, pending internal approvals are ready for upload.
6. Checks and verifies that all documents are complete and ready for upload into the lead health home systems.
7. Responds to inquiries on the enrollment status and update submissions to the outreach teams.
8. Support the department's administrative goals and requirements
9. Follows best practice and clinical standards, and adheres to departmental and State guidelines.
10. Performs all other duties or actions as required

Qualifications

• High school diploma or equivalent is required.
• Associate' s degree is preferred. At least three years of equivalent experience will be considered in lieu of degree.
• Excellent organizational, communication and interpersonal skills.
• Strong customer service experience, preferably in a provider services call center or billing department.
• Strong track record in performing comfortably in a fast-paced, deadline-oriented work environment.
• Proficient in Microsoft Office suite and other Web based platforms.
• Ability to work as a team member and independently.
• Ability to successfully execute multiple tasks simultaneously.
• Experience in a health care environment.
• Strong understanding of provider billing practices and claim processing.

Must be able to remain in a stationary position for an extended period of time.

Equal Opportunity Employer

Essen Health Care is proud to be an equal-opportunity employer, and we seek candidates who desire to work in and serve an ethnically diverse population.