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Enrollment Specialist

Grand Rapids, Michigan

Job ID: 10095 Category: Professional

Job Description

  • Monday - Friday: 8:00am to 5-pm with an hour unpaid for lunch
  • Details data entry (enrolling MAPD applications, Medigap applications, Supplemental applications, Return mail, and other misc changes).Promptly and effectively process all government program enrollment requests in compliance with all regulatory requirements and accreditation standards.
  • This includes timely entry and maintenance of data into Facets after review and analysis of electronic and hard copy information.
  • Process Medicaid and/or Medicare enrollment requests in a timely and accurate manner in compliance with state and federal regulations and accreditation standards.
  • Communicate as required with internal/external customers regarding member enrollment status through Facets documentation, phone calls and written correspondence, including use of approved form letters.
  • Analyze multiple reports from various internal and external sources to determine and implement appropriate action to reconcile enrollment discrepancies.
  • Conduct research as necessary to effectively resolve customer issues and respond to customer inquiries in a timely manner.
  • Courteously provide customers with information and education concerning government program enrollment processes and requirements.
  • Maintain an understanding of state and federal requirements and accreditation standards that impact the enrollment process.
  • Maintain an understanding of all internal and external computer systems and reports that impact the enrollment process.
  • Able to follow direction without supervision

 

Qualifications:

  • Previous enrollment processing experience and astute analytical skills to interpret complex eligibility files and data    
  • High School diploma - Required,
  • Two years’ experience in a health related field - required Minimum of two years managed care experience - required
  • Must have attention to detail and team-oriented
  • Must have excellent communication skills
  • Excellent analytical and problem-solving skill are required
  • Decision-making skills are essential as is the ability to assume responsibilities as delegated
  • Must have strong organizational skills, with attention to detail and ability to multi-task, mange multiple priorities and meet deadlines.
  • Associate's Degree -Preferred Enrollment Position Experienced - Preferred Experience with Medicare/Medicaid regulations - Preferred Excellent computer skills proficiency with Microsoft Office applications          
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