Healthcare Enrollment Coordinator
1 week ago
VNS Health is seeking a highly motivated and detail-oriented Enrollment Specialist to excel in the referral and enrollment process for VNS health plan services. As an Enrollment Specialist, you will play a critical role in ensuring timely and accurate processing of referrals, and providing exceptional customer service to our internal and external customers.
Key Responsibilities:- Provides education on VNS Health plans benefits and eligibility requirements to consumers.
- Reviews and confirms potential enrollees' eligibility, collaborating with New York Medicaid Choice (NYMC) in scheduling New York Independent Assessor (NYIA) assessments.
- Offers assignment of Medicare assistance as needed.
- Responds to inquiries regarding pre-enrollment issues, eligibility, and program information to ensure service satisfaction.
- Works with internal and external customers to ensure referrals are processed and followed up in a timely manner.
- Participates in outreach to potential enrollees referred via our referral inbox and/or fax, reviewing their eligibility and transferring them to the appropriate program.
- Processes daily submissions received internally for enrollment to Maximus via the portal.
- Maintains member record system with new employee enrollment documents.
- Works collaboratively with various departments and vendors to ensure consumers are enrolled in a timely manner.
- Ensures Auto (State mandatory) enrolled members are uploaded to Share Point for vendor assignment.
- Prepares monthly enrollment report for new enrollees, start of care authorizations, and care manager assignment.
- Assists in the monitoring and updating of our Health Commerce System case list.
- Provides education on CDPAS process and requirements for members interested in receiving CDPAS services.
- Maintains and documents actions taken in our CDPAS membership tracking database and uploads completed CDPAS Acknowledgment forms and MD Orders.
- Receives and processes daily Care Management (CM) and Utilization Management (UM) Activities request for vendor assignment.
- Schedules SCIC and assessment request received via Share Point for Select Health members.
- Conducts daily outreach to potential enrollees to confirm acceptance of hours offered and completion of 3-way transfers calls with the potential enrollee and NYMC prior to the deadline.
- Valid NYS driver's license or NYS non-driver's ID.
- Associate's Degree in health, human services, or other related discipline, or the equivalent work experience.
- Minimum two years experience in customer service.
- Proficient interpersonal, organizational, strong attention to detail, analytical, and writing skills.
- Knowledge of Medicaid eligibility requirements.
- Proficiency with personal computers, including MS Excel, Word, and Outlook.
VNS Health offers a competitive compensation package, including a generous paid time off policy, health insurance plan, employer-matched retirement savings funds, and opportunities for professional growth and career advancement.
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