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Enrollment Specialist
2 months ago
We are seeking a highly skilled Enrollment Analyst to join our team at Community Health Group. As an Enrollment Analyst, you will play a critical role in maintaining enrollment data integrity and ensuring compliance with applicable regulations.
Key Responsibilities- Update enrollment records by analyzing data from various sources, including DHCS and CMS, and determining necessary actions.
- Perform enrollment audits to identify and address data discrepancies.
- Process and mail enrollment and disenrollment correspondence to members.
- Process block transfer requests and ensure adherence to applicable requirements.
- Ensure accurate and efficient processing and evaluation of applications, maintenance and updating member records, timely and accurate communication, data integrity using various methods and systems.
- Support the enrollment month-end processes, including review of QNXT Trouble Shooter reports.
- Communicate effectively and accurately with customers, including providers, members, and peers.
- Demonstrate sensitivity in working with personal and confidential records and information, adhering to HIPAA and other related practices and policies.
- Bachelor's Degree preferred.
- Minimum of five years of experience in the healthcare industry, preferably in Enrollment related activities.
- Knowledge of Medicare Managed Care Enrollment and Disenrollment Manual, Chapter 2.
- Knowledge of CFR 422 and all other applicable codes and regulations.
- Strong customer service background.
- Strong experience and familiarity with data from multiple enrollment sources.
- Experience with and sensitivity to cultural background and linguistic needs of membership.
- Excellent communication and interpersonal skills.
- Ability to exercise mature and independent judgment.
- Strong knowledge of Excel.
- Required to work evenings and weekends.
- Prolonged periods of sitting.
- Extensive use of telephone.
