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Enrollment Coordinator
2 months ago
We are seeking a highly organized and detail-oriented Enrollment Coordinator to join our team at Santa Clara County Health Plan. As an Enrollment Coordinator, you will play a critical role in ensuring the accuracy and timeliness of enrollment and eligibility data for our members.
Key Responsibilities:- Complete data entry for Medicare paper applications and workflow tasks for all Medicare enrollment and disenrollment requests.
- Analyze, verify, and resolve beneficiary enrollment, disenrollment, eligibility, demographics, and primary care provider assignment changes and issues.
- Accurately document and code all contacts and follow-up actions for member, provider, and other communications and activities.
- Track, analyze, validate, and process assigned daily, weekly, and monthly enrollment and membership eligibility, integrity, audit, reconciliation/validation, and error reports.
- Identify, investigate, troubleshoot, and report eligibility and enrollment issues, errors, and/or discrepancies.
- Provide input to required internal and external reporting, including dashboards.
- Ensure process for delivering member materials to new and existing members is completed accurately and within the required timeframe.
- High School Diploma or GED.
- Minimum one year of experience in jobs requiring interaction with members/patients/clients/customers, with preference for experience working in a healthcare setting.
- Able to efficiently alternate focus between telephone and non-telephone tasks to support Department operations as dictated by business needs.
- Prior experience with managed care plans, Medi-Cal and Medicare programs, and working with underserved populations.
- Work weekends and company holidays as needed based on business and regulatory requirements.
- Spanish, Vietnamese, Chinese, or Tagalog language bi-lingual skills.
- Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications, such as Outlook, Word, and Excel.
- Ability to use a keyboard with moderate speed and a high level of accuracy.
- Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP members and providers over the telephone, in person, or in writing.
- Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes.
- Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position.
- Ability to maintain confidentiality.
- Ability to comply with all SCFHP policies and procedures.
- Ability to perform the job safely with respect to others, to property, and to individual safety.
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.
Physical Requirements:- Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time.
- Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds.
- Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less.
- Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment.
- Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone.
- Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail.
General office conditions. May be exposed to moderate noise levels.
EOE
