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Senior Enrollment Specialist
2 months ago
We are seeking a highly motivated and detail-oriented Senior Enrollment Specialist to join our team at VNS Health. As a key member of our enrollment team, you will be responsible for initiating the referral and enrollment process for our health plan services, ensuring timely and accurate processing of enrollments, and providing exceptional customer service to our members and internal stakeholders.
Key Responsibilities- Initiate the referral and enrollment process for VNS Health plan services, ensuring timely and accurate processing of enrollments.
- Perform outreach to assess eligibility and troubleshoot inquiries related to enrollment issues.
- Collaborate with New York Medicaid Choice (NYMC) in scheduling New York Independent Assessor (NYIA) assessments, including follow-up to obtain CFEEC scheduled dates and outcomes as needed.
- Offer assignment of Medicare assistance as needed.
- Respond to inquiries regarding pre-enrollment issues, eligibility, and program information to ensure service satisfaction.
- Work with internal and external customers to ensure referrals are processed and followed up in a timely manner.
- Participate in outreach to potential enrollees referred via our referral inbox and/or fax, reviewing their eligibility and transferring them to the appropriate program.
- Schedule NYIA assessments and follow up as needed to obtain NYIA scheduled assessment dates and outcomes.
- Process daily submissions received internally for enrollment to Maximus via the portal.
- Maintain member record system with new employee enrollment documents.
- Work collaboratively with various departments and vendors to ensure consumers are enrolled in a timely manner.
- Ensure Auto (State mandatory) enrolled members are uploaded to Share Point for vendor assignment.
- Prepare monthly enrollment report for new enrollees, start of care authorizations, and care manager assignment.
- Assist in the monitoring and updating of our Health Commerce System case list.
- Provide education on CDPAS process and requirements for members interested in receiving CDPAS services.
- Provide outreach to new enrollees and current members and their PCPs to obtain new or recertification MD Orders for continued CDPAS services.
- Maintain and document actions taken in our CDPAS membership tracking database and upload completed CDPAS Acknowledgment forms and MD Orders.
- Receive and process daily Care Management (CM) and Utilization Management (UM) Activities request for vendor assignment.
- Create activities for follow-up as needed.
- Schedule SCIC and assessment requests received via Share Point for Select Health members.
- Conduct 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, required.
- Associate's Degree in health, human services, or other related discipline, or the equivalent work experience, required.
- Minimum two years experience in customer service, required.
- Proficient interpersonal, organizational, strong attention to detail, analytical, and writing skills, required.
- Knowledge of Medicaid eligibility requirements, required.
- Proficiency with personal computers, including MS Excel, Word, and Outlook, preferred.
- Prior experience in Call Center setting, preferred.
