ESSENTIAL DUTIES AND RESPONSIBILITIES

• Reviews and completes Medicaid and other health plan enrollment applications.
• Contacts high-level hospital employees via email and by phone.
• Contacts payers on a regular basis to obtain the status of enrollment applications.
• Reviews enrollment requirements for payers and ensures that all updates are submitted timely.
• Ensures that enrollment statuses are up to date and that they do not expire, if possible.
• Updates hospital addresses with payers on a regular basis.
• Sets up online access for employees.
• Reviews and applies CMS enrollment regulation guidelines.
• Escalates any outstanding items to supervisors and Client Services team.
• Determines appropriate steps to take on account and refers accounts to appropriate inter-department roles, when needed.
• Other duties as assigned

QUALIFICATIONS AND REQUIREMENTS

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or abilities.

• 2 to 3 years’ experience working with insurance providers in role utilizing interpersonal skills
• Understanding of health plan enrollment and terminology associated with this process.
• Ability to research trends and address positive/negative trends timely.
• Results-oriented with a positive outlook
• Knowledge and experience working with government insurance programs and healthcare system
• Experience implementing best practices.
• High comfort level working in a time sensitive, diverse, and fast pace environment.
• Sense of urgency, a balance between analytical and intuitive skills and a willingness to “roll-up sleeves” and apply these attributes.
• Demonstrated strong listening and oral communication skills on an individual and group basis on all levels; excellent writing skills
• Adaptability - Adapts to changes in the work environment; Changes approach or method to best fit the situation.
• Communications – Exhibits good listening and comprehension, verbal and writing skills; Keeps others adequately informed. Excellent interpersonal skills and a collaborative management style.
• Judgment – Exhibits sound and accurate judgment; Includes appropriate people in decision-making process.
• Planning and Organizing – Uses time efficiently; Plans for additional resources; Sets goals and objectives.
• Working knowledge of computer functions including the internet and computer software such as Microsoft Office Suite and the ability to learn in-house computer applications
• Proven track record of ability to work independently
• Demonstrated ability to balance and prioritize numerous tasks, requests, systems, employee, and client urgencies.
• Ability to interface well with all departments within the company and to represent the respective executive officer in a highly professional manner.