ur client, a large nonprofit healthcare facility, is seeking a qualified candidate to join their team as a temporary enrollment coordinator.
Length of assignment- 3 months with possible extension
Pay: 28.00 per hour
Hours: Monday- Friday 9am-5pm
Hybrid schedule
MUST BE FLUENT IN BENGALI OR CHINESE
Responsibilities:
· Receives and evaluates referrals for appropriateness of membership.
· Submit referrals to Intake coordinators that were received by electronic methods, fax and telephone.
· Enters enrollee data and clinical information into Market Prominence (MP) and ensures the completeness and accuracy of the demographic information to successfully manage and report outcomes to leadership and to governing bodies.
· Verifies enrollee date of birth, sex, address, social security number, Medicaid number and Medicare number.
· Function in tandem with teammates to ensure all NTUCs are closed promptly upon receiving formal NTUC note.
· Collaborates with Clinical Enrollment to accurately close NTUC within 24 hours of receiving reason code with NTUC note
· Accurately enters request for service authorizations into HealthRules Health Rules Payor in accordance to department guidelines.
· Collaborates with the Clinical Enrollment on chart sign off and notifies RN supervisors of errors in documentation.
· Ensures that request for service authorizations are entered into accurately and timely and matches the supporting documents as it pertains to the new members
· Completes enrollment acceptance or deferral calls according to specified deadlines and ensures to document accordingly in MP.
· Acceptance calls are completed and documented within 24 hours of acceptance on E- File.
· Deferral calls are completed and documented before a members projected SOC and documented in Market Prominence. Calls given to bilingual staff are followed up on to ensure timeliness and thorough documentation.
· Provides exceptional customer service during phone calls received and outgoing on the ACD line.
· Maintains up-to-date knowledge of programs.
Qualifications:
· HS Diploma or equivalent required. Associates degree or higher preferred.
· A minimum of one year’s work experience in office settings
Microsoft Office
Telephone, computer and e-mail skills
Excellent written and oral communication skills
Demonstrates principles of customer service
Initiates and undertakes self-directed activities
Critical thinking and problem-solving skills
Good judgement and sense of urgency