Enrollment Coordinator

DOCTORS HEALTHCARE PLANS, INC.•Coral Gables, FL

About The Position

The Enrollment Specialist is responsible for performing duties related to enrollment of Medicare beneficiaries. These duties include, but are not limited to: processing enrollment applications, working service requests received from members regarding demographic changes and other member requests, tracking letters generated and sent to members, etc. Excellent customer service skills (friendly, courteous and helpful).

Requirements

A minimum one-year related healthcare experience including Medicare Part D and patient/beneficiary services
Understanding of healthcare terminology and definitions
Excellent oral and written communication skills; including good grammar, voice and diction
Bilingual (English/Spanish)
Proficient in MS Office with basic computer and keyboarding skills
Detail oriented and highly organized
Must be able to work overtime and/or weekends depending on business needs

Responsibilities

Understands CMS Enrollment and Disenrollment Guidelines
Analyze the member application and accompanying documents, ensuring applicant eligibility
Accomplishes daily enrollment, plan changes and disenrollment operations, including application review and processing applications into system.
Adheres to processing guidelines and timeliness requirements as defined by CMS
When necessary, conducts outbound calls to beneficiaries in order to request missing information for enrollment applications
Monitors and works closely with providers to obtain confirmation of condition for members enrolled in Chronic Special Needs plans
Review and update PCP reports, error reporting, daily processing files from CMS and other process related tasks
Responsible for the processing of returned mail to ensure integrity of member records
Review and mail all letters to members in accordance with regulatory guidelines
Assist department with all functions on an as needed basis in regards to enrollments, disenrollments, LEP, OOA, Enrollment and Disenrollment Monthly Matrix, CTM and RPC cases
Comply with all applicable Policies and Procedures
Must be able to prioritize work with administrative deadlines
Show initiative in problem solving
Able to work independently as well as in a team
Be reliable in attendance and give ample notice for absences
Work with a positive attitude