Enrollment Specialist

Overview

We are recruiting for a Bi-lingual Enrollment Specialist to join our team at our Corporate site in Fresno, CA.

The Enrollment Specialist plays an important role in helping children and families enroll in the Medi-Cal Program. In addition to helping families complete and submit the online applications, Enrollment Specialists also keep families informed about program changes and help them maintain their health coverage. They also help families who do not qualify for the Medi-Cal Program by referring them to other available programs. Additional when not performing enrollments, the position is responsible for the efficient and effective scheduling of site appointments. Answer incoming telephone calls from patients and physician offices calling to schedule Medical, Dental, CPSP, Behavioral Health and Health Education appointments. Plans, organizes, monitors and reports as necessary. Confirms appointments per established protocol. Secures patient information for charting, billing and record keeping purposes. Ensures that established information is obtained in order to pre-register patients.

Responsibilities

This position is directly responsible for supporting the sites by improving UHC's revenue cycle through new enrollments and recertification's. The Enrollment Specialist is familiar with the screening and evaluative processes necessary to determine a patient's eligibility for Medi-Cal, (including Medi-Cal Dental and Presumptive Eligibility), Family PACT, CDP, Covered California and Sliding Fee Program, or any other program that may assist our patients financially. Providing patient support services by telephone.

• Assist applicants in properly completing the application and answering their questions.
• Ensure the confidentiality of all applications, records, and any information received in written, graphic, oral, or other tangible forms.
• Review and explain the documents that are required with the application.
• Refer applicants, when necessary, to the county Department of Social Services (DSS) for Medi-Cal if they need more information or assistance with complex issues or other programs
• Assist applicants in estimating their monthly premiums.
• Overall knowledge of the revenue cycle process, registration, insurance verification, precertification, billing compliance, payer contracts, patient estimation, financial assistance.
• Schedules, educates, registers, verifies and estimates services for the patient, updates insurance and demographic information for all UHC health services
• Answers incoming calls on a multi-line phone.
• Makes outbound calls to confirm and obtain pre-registration information.
• Promptly and courteously answers and screens phone calls for the department; routes call as appropriate within established customer service guidelines; accurately records messages and delivers to the appropriate party in a timely manner; checks voicemail frequently.
• Maintains their patient schedule to ensure maximum production of enrollment applications.
• Provides outstanding customer service to internal and external customers.
• Reports any potential customer concerns or complaints immediately to Enrollment Manager.
• Review enrollment documentation to ensure that they are prepared properly and follow-up when necessary.
• Must build community long term relationships to ensure future enrollment engagement and opportunities.
• Fosters an environment that promotes teamwork and positive communications within the service area and department.

Qualifications

EDUCATION AND LICENSE / CERTIFICATION :

PRIOR EXPERIENCE :

SKILLS

PHYSICAL REQUIREMENTS

The hourly wage range that UHC reasonably expects to pay for the position upon hire starts at $21 an hour. Our salaries are dependent on knowledge, skills, and experience.

In addition, our comprehensive benefits package for regular status employees includes :