Enrollment Coordinator

Doctors Healthcare Plans • Coral Gables, FL

1d

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

Nice To Haves

• 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

Responsibilities

• Understand CMS Enrollment and Disenrollment Guidelines
• Analyze the member application and accompanying documents, ensuring applicant eligibility
• Accomplish daily enrollment, plan changes and disenrollment operations, including application review and processing applications into system.
• Adhere to processing guidelines and timeliness requirements as defined by CMS
• Conduct outbound calls to beneficiaries to request missing information for enrollment applications
• Monitor and work 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
• Process 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

Benefits

• Consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed