Enrollment Analyst

1 week ago

Dayton, Ohio, United States ALTA IT Services, LLC Full time $80,000 - $120,000 per year

Job Title: Enrollment Analyst

Location: Dayton, Ohio

Type: Contract

Contractor Work Model: Remote

Title:  Enrollment Analyst

ALTA is supporting a contract opportunity working 100% remote.

ALTA IT Services is a wholly owned subsidiary of System One, a leading provider of specialized workforce solutions and integrated services. ALTA is an established leader in IT Staffing and Services, for both government and commercial enterprises across the United States, specializing in Program & Project Management, Application Development, Cybersecurity, Data & Advanced Analytics, and Agile Transformation Services.

The Enrollment Specialist II is responsible for reviewing files and interpreting data to enter members into eligibility systems according to appropriate regulatory guidelines.

Essential Functions:

  • Process work items according to appropriate regulatory guidelines
  • Review files and interpret the data to enter members into eligibility systems
  • Completion of daily change file pre-processor exceptions and monthly full file pre-processor exceptions
  • Research member eligibility and take appropriate actions to resolve issues across all eligibility systems
  • Process mass Primary Care Physician (PCP) changes with Provider Operations
  • Research, review, and interpret eligibility data to respond to eligibility inquiries from contracted vendors
  • Access state and federal government systems to review and confirm eligibility status
  • Process paper applications received for all applicable lines of business
  • Inbound phone coverage to answer inquiries from both internal and external customers
  • Complete all required corporate training within stated timelines to a satisfactory manner
  • Performs any other job related duties as requested.

Education and Experience:

  • High School or GED required
  • Associates of Science (A.S) in accounting, finance or business related field preferred
  • Equivalent years of relevant work experience may be accepted in lieu of required education
  • Two (2) years of healthcare, insurance, or related industry experience to include at least one

(1) year of enrollment/eligibility or similar experience required

Competencies, Knowledge and Skills:

  • Familiarity with Microsoft Word and Excel
  • Excellent verbal and written communication skills
  • Ability to work independently and within a team environment
  • Attention to detail
  • Familiarity of the healthcare field
  • Knowledge of Medicaid and Medicare preferred
  • Critical listening and thinking skills
  • Proper grammar usage
  • Time management skills
  • Proper phone etiquette
  • Customer service oriented
  • Decision making/problem solving

Licensure and Certification:

  • None

System One, and its subsidiaries including Joulé, ALTA IT Services, and Mountain Ltd., are leaders in delivering outsourced services and workforce solutions across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.

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Ref: #860-IT Cincinnati

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