Medicare Eligibility Specialist
About The Position
Join VillageCare as a Full-Time Medicare Eligibility Specialist and be part of a dynamic team that plays a crucial role in transforming lives through health care solutions. In this position, you will have the opportunity to utilize your problem-solving skills to assist individuals in navigating the complexities of Medicare eligibility. With a competitive pay range of $31.89 - $35.88 per hour, you will be rewarded for your expertise while making a tangible difference in the lives of our customers. This role empowers you to embrace a customer-centric approach, ensuring excellence and integrity in every interaction. Seize this chance to contribute to a forward-thinking organization that values smart solutions and fosters innovation in the health care industry. VillageCare: Our Mission VillageCare is a community-based, not-for-profit organization serving people with chronic care needs, as well as seniors and individuals in need of continuing care and managed care services. Our mission is to promote healing, better health and well-being to the fullest extent possible. Our care is offered through a comprehensive array of community and residential programs, as well as managed care. VillageCare has delivered quality health care services to individuals residing within New York City for over 45 years. Your role as a Medicare Eligibility Specialist The role of the Medicare Eligibility Specialist at VillageCare is essential in ensuring the integrity of our enrollment processes for Medicare products. You will be responsible for conducting daily quality assurance on enrollment and disenrollment files from the State and CMS, maintaining an accurate enrollment census, and reconciling VillageCareMAX membership systems. This position involves outreach to BPaaS vendors to address eligibility discrepancies and system issues, ensuring that all pertinent information is communicated effectively to your supervisor for timely resolution. You will play a key part in facilitating monthly and yearly audits of Medicare applications, ensuring compliance with state guidelines for cancellations and disenrollments. Additionally, you will oversee the distribution of enrollment and disenrollment letters, updating internal teams on relevant reports. Your contributions will directly support our mission of excellence in healthcare service delivery as you assist the Manager of Medicare Eligibility and the Business Development team in achieving departmental goals. Does this sound like you? To excel as a Medicare Eligibility Specialist at VillageCare, candidates must possess a robust combination of healthcare experience and analytical skills. A minimum of 5-7 years of relevant experience is essential, ensuring you are well-versed in the intricacies of Medicare and Medicaid systems. A Bachelor's Degree is required, providing a strong educational foundation for this role. Proficiency in various software tools related to enrollment and disenrollment processes is crucial for maintaining accurate membership records and conducting quality assurance. Strong problem-solving skills are necessary for resolving discrepancies and ensuring compliance with state guidelines. Effective communication skills are vital, as you will be liaising with internal teams and external BPaaS vendors to address issues promptly. Attention to detail and the ability to manage multiple tasks in a fast-paced environment will contribute significantly to your success in this pivotal role, facilitating the smooth operation of Medicare eligibility processes.
Requirements
- A minimum of 5-7 years of healthcare experience
- Bachelor's Degree
- Proficiency in various software tools related to enrollment and disenrollment processes
- Strong problem-solving skills
- Effective communication skills
- Attention to detail and the ability to manage multiple tasks in a fast-paced environment
Responsibilities
- Conducting daily quality assurance on enrollment and disenrollment files from the State and CMS
- Maintaining an accurate enrollment census
- Reconciling VillageCareMAX membership systems
- Outreach to BPaaS vendors to address eligibility discrepancies and system issues
- Facilitating monthly and yearly audits of Medicare applications
- Overseeing the distribution of enrollment and disenrollment letters
- Updating internal teams on relevant reports
- Assisting the Manager of Medicare Eligibility and the Business Development team in achieving departmental goals
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
