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Enrollment Specialist

4 months ago

Boston, United States Fenway Health Full time
Job DescriptionJob DescriptionDescription:

Under the supervision of the Director of Patient and Financial Services, the Enrollment Specialist is responsible for the registration and documentation of patients eligible for financial assistance, and the provision of excellent customer service.


Representative Duties

Register, Document, and Maintain Patients Eligible for Financial Assistance

  • Meet with uninsured clients for financial assistance assessment as part of first appointment for service
  • Meet with HIV clients for financial assistance/planning/assessment
  • Complete assessment, determine eligibility, identify best source of assistance, assist client with necessary forms and documentation, and determine level of financial assistance
  • Enter all client information into system: 1) Financial Assistance source - FreeCare, ACT NOW, CenterCare, Sliding Fee Schedule (Fee Agreements), Ryan White CARE Act Title 1
  • Assist clients with coverage problems/questions regarding theses programs
  • Work with appropriate FCHC staff regarding overdue accounts to determine eligibility for financial assistance prior to bad debt consideration
  • Work closely with the Medical Social Workers and other staff in developing patient financial assistance plans
  • Implement system for "early intervention" with overdue accounts to develop payment plan and/or identify available financial assistance
  • Work with appropriate FCHC staff to ensure the adherence to state guidelines concerning un-collectible balances for accounts under the Financial Assistance Program
  • Follow up with clients to ensure they’ve scheduled and followed through with medical appointments Assist with any problems/issues that may arise

Accurately set up referrals for managed care patients and inform provider in a timely manner

  • Greet each client with a smile and a welcoming, professional manner
  • Answer each phone call in a cheerful and professional manner
  • Give patients clear directions to the relevant waiting area and clear instructions to wait there to be called
  • Provide clients with correct and accurate information regarding FCHC services and providers
  • Ask for input from team colleagues if unsure of correct response to inquiries
  • Refer unusual or difficult situations to supervisor
  • Refer managed care inquiries to appropriate medical staff member
  • Actively build good working relationships with colleagues and providers

Educate patients, providers and staff to the various managed care programs

  • Educate patients toward proactive use of managed care companies and referral authorization process
  • Inform providers and /or patients of plan changes
  • Transcribe letters of introduction to referring doctors, employers and related services provided for patients

Monitor and update managed care member listings and verify membership eligibility

  • Transfer plan updates in provider book to replace obsolete information
  • Update specialty provider office or admin changes in rolodex and/or provider manual
  • Meet with plan representative to learn updates or pertinent referral information

Provide excellent customer service

  • Greet each client with a smile and a welcoming, professional manner
  • Answer each phone call in a cheerful and professional manner
  • Give patients clear directions to the relevant waiting area and clear instructions to wait there to be called
  • Provide clients with correct and accurate information regarding FCHC services and providers
  • Ask for input from team colleagues if unsure of correct response to inquiries
  • Refer unusual or difficult situations to supervisor
  • Refer managed care inquiries to appropriate medical staff member
  • Actively build good working relationships with colleagues and providers

Meets agency participatory expectation

  • Adheres to all agency and departmental policies and procedures
  • Participates in quality assessment and improvement activities as requested
  • Adheres to the highest principles of client confidentiality
  • Adheres to established safety policies, procedures and precautions; identifies potential or actual unsafe situations in the environment and takes measures to rectify the situation
  • Attends all required meetings, in-services and professional trainings Maintains professional competence necessary to perform job responsibilities; maintains and provides agency with records of continuing education activities
  • Serves on agency committees and in professional organizations when requested

Performs other related duties as requested

Requirements:
  • Strong computer experience
  • Calm, flexible and understanding manner
  • Ability to work harmoniously and effectively with colleagues, patients, clients and vendors across the spectrum of diversity, including but not limited to race, ethnicity, color, gender identity, sexual orientation, age, socio-economic status, national origin and immigrant status, religious or spiritual identity, disability (physical, mental, emotional and developmental), veteran status, and/or limited English proficiency.
  • Willingness to contribute towards Fenway’s efforts in becoming an anti-racist organization and promoting a culture dedicated to ongoing development in service of humility, equity, diversity, inclusion, and belonging, where differences are acknowledged and valued.

Preferred Qualifications

  • Bachelor’s Degree or 3 years of experience
  • Knowledge of business procedures and health care
  • Successful customer service experience
  • Bilingual Spanish/English
  • Experience with Epic


Physical Requirements:

  • Ability to meet the following physical requirements with or without reasonable accommodations:
  • Sit at a computer station for extended periods of time
  • Ability to keyboard for extended periods of time

We offer competitive salaries, and for those who qualify, an excellent benefits package; including comprehensive medical and dental insurance plans, and a retirement plan with employer match. We also provide 12 paid holidays, paid vacation, and more.

LGBTQIA+ identified persons, Black, Indigenous, and other people of color (BIPOC), and individuals from other historically underrepresented communities are strongly encouraged to apply.