Enrollment Technician

Dignity Health Management Services•Bakersfield, CA

40d•Remote

About The Position

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric, full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups, hospitals, health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first. Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art, flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options, including medical, dental and vision plans, for the employee and their dependents, Health Spending Account (HSA), Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave. One Community. One Mission. One California Job Summary and Responsibilities This position may be filled as a Level I or Level II, dependent upon the final candidate's experience. As the Enrollment Technician, you will coordinate and oversee the membership enrollment process for various health plans. This role involves reconciliation of membership data against capitation payments received from delegated health plans, assisting with enrollment issues, and supporting department goals through leadership in data integrity and workflow optimization.Every day you will expertly assist health plans and employer groups, verify documentation, clarify program requirements, and meticulously process applications, ensuring accuracy and compliance with all established guidelines.To be successful, you will demonstrate outstanding communication skills, strong attention to detail, and the ability to manage multiple priorities. Oversees the processing of enrollment and eligibility files for all lines of business, ensuring high-quality standards are maintained. Reconciliation of membership data against capitation payments from delegated lines of business, identifying discrepancies and implementing corrective actions. Acts as a primary point of contact with health plans and employer groups to resolve questions on member enrollment, including escalated issues. Verifies and validates data sets, such as Primary Care Physicians, effective dates, member coverage, and plan benefits, providing support to junior team members. Maintains, processes, and audits eligibility files within the database to ensure the highest levels of data integrity and accuracy. Supports Configuration partners (Contracting and Benefits) to streamline processes and enhance departmental efficiencies Develops and maintains process documentation and training materials, assisting in training new staff and mentoring junior colleagues (as a Level II). This position is work from home within California.

Requirements

3-5+ years of experience in an administrative role with related experience (e.g., office administration support, insurance services, customer service, etc.).
Demonstrated experience in handling complex enrollment and eligibility processes (as a Level II).
High School diploma or GED (for Level I) or Associates Degree in a relevant field (e.g., healthcare management, business administration) or 3 years of related job or industry experience in lieu of degree (for Level II).

Nice To Haves

3-5+ years of experience in the Managed Care/Healthcare Industry preferred.
Experience with HMO health plans preferred.
Experience navigating health plan portals preferred.
Experience with EZCap preferred.
Experience with Google Workspace a plus.
Experience with process improvement methodologies (e.g., Lean, Six Sigma) preferred.
Bachelors Degree in Business Administration or a related field preferred.
Certification in Healthcare Administration or Managed Care preferred.
Advanced Excel skills, including pivot tables, VLOOKUP, and data analysis functions.

Responsibilities

Oversees the processing of enrollment and eligibility files for all lines of business, ensuring high-quality standards are maintained.
Reconciliation of membership data against capitation payments from delegated lines of business, identifying discrepancies and implementing corrective actions.
Acts as a primary point of contact with health plans and employer groups to resolve questions on member enrollment, including escalated issues.
Verifies and validates data sets, such as Primary Care Physicians, effective dates, member coverage, and plan benefits, providing support to junior team members.
Maintains, processes, and audits eligibility files within the database to ensure the highest levels of data integrity and accuracy.
Supports Configuration partners (Contracting and Benefits) to streamline processes and enhance departmental efficiencies
Develops and maintains process documentation and training materials, assisting in training new staff and mentoring junior colleagues (as a Level II).