Job Summary:
We are seeking an experienced Enrollment Coordinator I to join our team. This role plays a crucial role in the enrollment process by reviewing and submitting enrollment requests subject to all CMS regulations. This position requires attention to detail to ensure the accuracy and timeliness of acknowledgements are sent to members. responsible for overseeing student admissions, recruitment, and enrollment processes at our educational institution.
Responsibilities:
- Review and submit enrollment request received as well as maintaining accuracy and timeliness of acknowledgment to members
- Resolve member issues and sustain quality member care
- Audits data entered into the internal systems to ensure data integrity and quality
- Analyzes and interprets out of area indicator reports submitted by CMS and determine action to be taken
- Identify trends and risks
- Stay up to date on all CMS Enrollment Regulations
- Ensure quality and compliance to meet applicable guidelines
- Ensure timely, accurate and complete submissions to CMS
- Review prospective enrollees are appropriately screened to meet eligibility requirements within regulatory guidelines and timelines
- Required member mailings are sent timely and within regulatory guidelines
- Responsible for ensuring the completeness, quality and eligibility criteria of member’s application to meet Enrollment Requirements.
- Ensure all completed applications are submitted within required time frames.
- Utilizes various computer systems and applications to perform daily functions.
- Understands the BEQ and TRR processes
Requirements and Skills
- High School Diploma
- Two years of Medicare Advantage Experience Required
- Knowledge of health plan benefits, processes and Operations
- Prior experience with Commercial and Medicare Advantage Plans
- Attention to detail and problem solving
- Excellent communication skills
- TPA Experience preferred
- Work weekends and company holidays as needed based on business needs
- Detailed Oriented with the ability to conduct research and identify steps to resolve issues to completion
- Ability to meet Enrollment timelines.
- Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position
Job Type: Full-time
Pay: $22.00 - $30.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- Dental insurance
- Health insurance
- Paid time off
- Vision insurance
Weekly day range:
- Monday to Friday
- Weekends as needed
Work setting:
Experience:
- Processing Medicare Enrollments: 2 years (Required)
Work Location: Remote