Enrollment Specialist /Admin

Enrollment functions

• Reviews enrollment details and effective dates to ensure accuracy prior to enrolling member.
• Works with team members to determine appropriate program enrollment.
• Enters, deletes, and revises enrollment related actions in Interchange.
• Affords assistance in the redetermination process and submits lists of all members to be renewed to appropriate external partners.
• Reviews and processes all requested and approved disenrollments, whether voluntary or involuntary, for TennCare LTSS members in an accurate and timely manner.
• Ensures effective dates are accurate and research discrepancies related to effective dates, preventing eligibility issues for members, providers, and MCOs.
• Communicates disenrollment's for the Katie Beckett program to program leadership.
• Transcribes approved PASRR determinations from the TMED system into the PERLSS system to allow for additional enrollment and eligibility actions to be taken on completed records.

Disenrollment functions

• Reviews and processes all requested and approved disenrollments, whether voluntary or involuntary, for TennCare LTSS members in an accurate and timely manner.
• Ensures effective dates are accurate and research discrepancies related to effective dates, preventing eligibility issues for members, providers, and MCOs.
• Communicates disenrollment's for the Katie Beckett program to program leadership.
• Transcribes approved PASRR determinations from the TMED system into the PERLSS system to allow for additional enrollment and eligibility actions to be taken on completed records.

Qualifications

• Graduation from an accredited college or university with a bachelor’s degree or graduation from an accredited college or university with an associate’s degree and two years of qualifying professional experience.
• Excellent verbal and written communications skills.
• Proven technical skills (e.g. Microsoft Word, Excel, Outlook, PowerPoint, SharePoint, etc.).
• Excellent time management skills and ability to multi-task and prioritize work in order to meet specific timeframes and deadlines with minimal supervision.
• Keen attention to detail and adherence to deadlines.
• Organization
• Self-motivated and able to thrive in a fast-paced and results-driven environment.
• Critical thinking and problem-solving skills.