OOS Provider Enrollment Specialist

6 days ago

Glen Burnie, United States Elevate Patient Financial Solutions Full time
Elevate Patient Financial Solutions has an exciting career opportunity available as an Enrollment Specialist. This position will be working remote supporting a team on EST. The Full Time schedule for this role will be Monday-Friday; 8am-5pmEST.

JOB SUMMARY

The Enrollment Specialist will support eligibility teams that work in the Woodlands, TX as well as all other Elevate PFS service lines. The primary focus of this role is to complete Medicaid and other government healthcare enrollments. The Enrollment Specialist is responsible for facilitation of quality enrollments, acting as a facilitator with hospital clients and payers as well as internal customers of the business. The Enrollment Specialist is an expert in health plan enrollment and holds ultimate accountability to ensure outcomes from enrollments by establishing and fostering compliant, quality work that meets best practice standards.

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.
  • Remote and Hybrid positions require a home internet connection that meets the company's upload and download speed criteria.
Benefits:
ElevatePFS believes in making a positive impact not only within our industry but also with our employees -the organization's greatest asset We take pride in offering comprehensive benefits in a vast array of plans that contribute to the present and future well-being of our employees and their families.
  • Medical, Dental & Vision Insurance
  • 401K (100% match for the first 3% & 50% match for the next 2%)
  • 15 days of PTO
  • 7 paid Holidays
  • 2 Floating holidays
  • 1 Elevate Day (floating holiday)
  • Pet Insurance
  • Employee referral bonus program
  • Teamwork: We believe in teamwork and having fun together
  • Career Growth: Gain great experience to promote to higher roles

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to, internal equity, experience, education, location, specialty and training. This pay scale is not a promise of a particular wage.

The job description does not constitute an employment agreement between the employer and Employee and is subject to change by the employer as the needs of the employer and requirements of the job change.

ElevatePFS is an Equal Opportunity Employer

Pay Range: $19.18 - $26.00 per hour

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