ECM Enrollment Specialist
About the role
The organization operates in the healthcare sector, focusing on person-centered healthcare, behavioral health services, and social supports. It addresses challenges faced by individuals who encounter barriers to obtaining or maintaining healthcare coverage, helping them access needed services to improve health, stability, and independence.
The ECM Enrollment Specialist plays a crucial role in assisting prospective members with navigating the administrative processes required to secure and maintain Medi-Cal healthcare coverage. This position ensures individuals move efficiently through enrollment and eligibility steps, enabling their transition into appropriate healthcare programs and supporting the organization's goal of expanding access to care.
Responsibilities
- Assist prospective members with Medi-Cal applications and renewals
- Guide members through documentation and verification requirements
- Monitor application status and follow up on pending cases
- Address eligibility issues, including denials and discontinuances
- Support appeals and submission of requested documentation
- Assist members with Managed Care Plan enrollment
- Track member progress until ready for program enrollment
- Coordinate handoffs between enrollment and care management teams
Requirements
- Experience with Medi-Cal applications and enrollment processes
- Ability to communicate eligibility requirements clearly
- Strong organizational skills to manage multiple cases and follow-ups
- Attention to detail in verifying documentation and application completeness
- Capability to work collaboratively with internal teams and external agencies
Pay
Hourly wage of $21.00 to $24.00, based on experience and qualifications