Enrollment & Eligibility Specialist
About The Position
Under the direction of the NeighborHealth PACE Senior Care Benefits Manager, the Enrollment and Eligibility Specialist will be responsible for the oversight of various services and insurance-related tasks that contribute to a frail elder’s initial and continued enrollment in NeighborHealth PACE by completing MassHealth applications and gathering all income, assets and health insurance verifications in a timely manner. Visits are conducted in person in the frail elder’s home, assisted living programs, Neighborhood PACE sites and long term care facility (after enrollment). We serve members in the following communities; East Boston, Chelsea, Winthrop, Revere, Everett, Malden, Medford, Melrose, Stoneham and Boston’s North End.
Requirements
- High Diploma
- 2 years’ experience in health care office setting performing health insurance enrollment functions
- Valid Massachusetts driver’s license and reliable transportation
- Achieve full bilingual fluency by passing EBNHC requirement for Bilingual Evaluation
Responsibilities
- Strong knowledge of MassHealth eligibility
- Strong knowledge of the overall Medicare eligibility of Part A, B and D
- Verifying all insurances prior to and throughout the participant’s enrollment with NeighborHealth PACE, this includes: online eligibility checks, initial and annual MassHealth applications and Medicare Secondary Payers Surveys
- Ensuring that all Medicare Part D YTD Explanation of Benefits are received and scanned into the system prior to enrollment.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
