Job Description

Description:

Job Title: Enrollment Associate I

Duration: 5 Months

Location: Fountain Valley, CA 92708

Description

Job Summary:

• The Enrollment Associate I is intended as MHS entry level position, responsible for analyzing and maintaining accurate membership eligibility and benefit plan information using the different health plan websites to enroll members through CLIENT application. The Enrollment Associate I works under direct supervision from more senior members of the enrollment team, and/or Claims management. The role is responsible for the accurate and timely response to all member eligibility requests and is accountable for the success of the assigned task.

Job Responsibilities:

• Manage personal queue, issues and tickets in ServiceNow and Workfront: Complete documentation, contract information and follow-up communication once issue is resolved.
• Maintain regular user contact and attend relevant meetings, and assists with contact for IS to ensure communication, collaboration, and teamwork. Identify and resolve problems and issues that arise in the application.
• Develops and maintains an ongoing awareness of CLIENT’s healthcare information systems initiatives, emerging technologies, and relevant laws and regulations in providing ongoing and competent support for assigned areas of responsibility.
• Complies with all Claims/IS Policies, Procedures and Standards including: Project Management tools/methodologies, Network/Systems Workstation Security, HIPAA Privacy and Security Regulations associated with Electronic Protected Health Information (ePHI).
• Be at work and be on time.
• Follow company policies, procedures and directives.
• Interact in a positive and constructive manner.
• Prioritize and multitask.
• Manage personal queues, issues or calls from customers for assistance. Complete documentation, contact information and follow-up communication once issue is resolved.
• Accurately update member eligibility information by verifying eligibility and benefit information using the various health plan websites. When necessary, communicate with the health plans by asking appropriate questions and being familiar with the terminology used. Effectively navigate through the system of record application to enroll these members.
• Resolve routine problems and issues associated with assigned applications to ensure high levels of availability and user satisfaction. Maintain contact with users and senior team members to ensure understanding of needs, assignments, and overall goals.
• Adheres to the department’s productivity goal in managing personal queue, issues and tickets in Service Now and Work Front, etc. within the established service level agreement.
• Maintains flexibility to undertake new assignments as required to react quickly and positively to changing priorities including but not limited to member demographics update, expired patient, shell coverage clean-up, dual coverage clean-up, Hospice report, and ERISA report.
• Work as a team player and communicates in a positive manner with co-workers, managers and other contacts in regards to best practices.
• Prioritize work to meet department deadlines and the needs of other departments. Keep supervisor/manager informed of issues pertaining to enrollment.
• Participates in education programs, in-service meetings and workshops to enhance professional growth and development.
• Participates in regular meetings with users and decision makers to ensure operational approval for all system initiatives.
• Perform any additional/miscellaneous duties as requested by the management team within the scope of knowledge/ability.

Required Skills & Experience:

• Ten (10) key skills. Accurate data entry or typing skills necessary.
• Basic insurance knowledge.
• Good written and verbal communication skills.

Preferred Skills & Experience:

• A minimum of one (1) year of experience in a business office environment.

Education:

Required Education:

• High school graduate or equivalent.

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