Enrollment Coordinator II

Nascentia Health•Syracuse, NY

1d•$21 - $27

About The Position

The Enrollment Coordinator II is responsible for assisting the Director of Customer Service and the Enrollment Supervisor in managing incoming calls, processing consumers inquiries/referrals, and processing all Managed Long-Term Care Plan (MLTCP) enrollments and disenrollments. Serves as an expert consultant for plan enrollments and dis-enrollments in addition to handling department escalations and audits. Through the direction of the Enrollment Supervisor, provides guidance and delegates necessary tasks to a team of Enrollment Coordinators. Assisting and overseeing daily Enrollment Coordinator responsibilities, which include regularly coaching and observing calls, answering incoming inquiries and referral calls. Processing plan enrollments and dis-enrollments. Communication and coordinating with internal teams as well as outside vendors, Local Department of Social Services (LDSS), and Maximus (sub-contractor for the Department of Health), Assistance. Processing Referrals, Prospective Enrollments, and Consumers in Zoho. Properly notating Guiding Care and Zoho with notes and appropriate alerts. Communicating changes and updates to enrollment and pre-enrollment members to the appropriate Care teams and Senior Leadership The Enrollment Coordinator II will act as a point of contact to assist team members with unfamiliar or unusual calls, enrollment, and dis-enrollment scenarios, and ensure the highest quality of customer service and best practices. Serves as an expert consultant to their peers in enrollment specific operating systems (Guiding Care, Zoho, Healthsuite, Maximus, Epaces, HCS) This position will exemplify expectation of continuous learning and evolving along-side new products and services within the Nascentia Health organization. Through the direction of the Enrollment Supervisor, helps to train and onboard both new and existing enrollment coordinators with new or remedial job training. Performance Responsibilities: Assist with and delegate tasks, projects, and changes from Enrollment Supervisor and Director of Customer Service and/or Senior Leadership. Collaborate and assist with the Enrollment Supervisor to maintain team coverage and monitor valuable department trends as needed. Assist with reporting, maintenance of training documents, and ZOHO to promote knowledge and development of the Enrollment Coordinator team. Respond to enrollment inquiries and provide detailed plan information to ensure understanding of plan benefits, maximizing member enrollment. Coaches and observes calls to identify process improvement opportunities and enhance overall call quality and efficiency. Answer calls and respond to customer complaints in the absence of Enrollment Supervisor. Works with the language assistance line for those who have limited English proficiency. Determines plan eligibility for Medicaid, Medicare, and integrated product lines. Obtain necessary information and/or documentation from external providers. Process all required enrollment files and information communicating to the appropriate state and local departments: Maximus, DOH, LDSS Track and report consumer and member key performance indicators for senior leadership as tasked Generate and process correspondence related to the enrollment and disenrollment processes. Adheres to Nascentia Health policies and procedures ensuring compliance with the Department of Health (DOH) and Centers for Medicare and Medicaid Services (CMS). Performs all other duties as assigned. The Enrollment Coordinator II must set an example as a positive and knowledgeable team member and subject matter expert to help maintain team cohesiveness and collaboration. The Enrollment Coordinator II must be friendly and build relationships that promote the development of potential new enrollees. The individual is patient, empathetic, and openly communicative. Problem-solving and confidence at troubleshooting should come naturally to resolve any consumer or internal complaints. The Enrollment Coordinator II must exemplify a positive representation of the Enrollment Team and the Communication Center while assisting with other departments and staff to meet the needs of the consumers.

Requirements

High school diploma.
Associates degree preferred in related field.
2 or more years experience in customer service and/or healthcare field.
Strong interpersonal, communication and problem-solving skills.
Ability to stay calm in difficult and stressful situations.
Demonstrates discretion in handling confidential and sensitive information, maintaining a positive and empathetic stance when dealing with all internal and external customers.
Strong working knowledge of, and experience using a wide variety of software platforms including Microsoft Office Suite (Outlook, Word, Excel and PowerPoint).
Demonstrate ability to work independently and collaboratively with the ability to adapt to shifting priorities and demands to meet hard deadlines.
Ability to sit or stand at a desk 90% of the day.
Frequent sitting, standing, walking.
Visual/hearing ability sufficient to comprehend written or verbal communication.
Ability to express oneself verbally and in writing.
Must be able to engage in real-time phone communication with clients, caregivers, and providers as a core job function.
Extended periods of computer use.
Ability to lift and move objects up to 40 pounds.
Bloodborne Pathogens Exposure Category III - Employee who rarely has contact with blood and body fluids

Nice To Haves

Associates degree preferred in related field.

Responsibilities

Assist with and delegate tasks, projects, and changes from Enrollment Supervisor and Director of Customer Service and/or Senior Leadership.
Collaborate and assist with the Enrollment Supervisor to maintain team coverage and monitor valuable department trends as needed.
Assist with reporting, maintenance of training documents, and ZOHO to promote knowledge and development of the Enrollment Coordinator team.
Respond to enrollment inquiries and provide detailed plan information to ensure understanding of plan benefits, maximizing member enrollment.
Coaches and observes calls to identify process improvement opportunities and enhance overall call quality and efficiency.
Answer calls and respond to customer complaints in the absence of Enrollment Supervisor.
Works with the language assistance line for those who have limited English proficiency.
Determines plan eligibility for Medicaid, Medicare, and integrated product lines.
Obtain necessary information and/or documentation from external providers.
Process all required enrollment files and information communicating to the appropriate state and local departments: Maximus, DOH, LDSS
Track and report consumer and member key performance indicators for senior leadership as tasked
Generate and process correspondence related to the enrollment and disenrollment processes.
Adheres to Nascentia Health policies and procedures ensuring compliance with the Department of Health (DOH) and Centers for Medicare and Medicaid Services (CMS).
Performs all other duties as assigned.