Enrollment Specialist

About the role

The Enrollment Specialist is responsible for assisting Mosaic patients with insurance applications and eligibility requirements for state and federal insurance programs, such as Oregon Health Plan. This role involves conducting outreach activities, developing and maintaining enrollment reports, and managing reports provided by the organization.

Responsibilities

• Contact patients for re-enrollment and assist the Billing Department with insurance verifications.
• Conduct Outreach activities with community partners and other organizations to provide information and enrollment assistance.
• Develop and maintain statistical enrollment reports and manage reports provided by the organization for enrollment and re-enrollment.
• Travel throughout the region to support enrollment assistance.
• Handle pre-registration and registration pre-verification for all patients at Mosaic, both new and established.
• Enter, audit, educate, and advocate for accurate registration in the patient's electronic medical record (EHR).
• Identify patients who have terminated from Medicaid/Medicare and reach out to them to inquire about the reason for termination, assisting them in the enrollment process.
• Provide education on Medicaid eligibility and sliding scale eligibility.
• Manage bi-lingual communication, with Spanish/English proficiency strongly preferred.
• Assist patients in applying for and verifying insurance coverage through state and federal systems.
• Timely document all assistance including insurance eligibility status in the electronic medical record (EMR) per procedure.
• Monitor enrollment reports to identify enrollment assistance needs and actively engage in patient outreach.
• Provide customer and access services, advising patients on their enrollment status and financial/insurance documentation requirements.
• Schedule patients for enrollment appointments and provide support for new patient and enrollment scheduling, rescheduling, and cancellations.
• Confirm patient demographics, registration, and insurance information and update the EHR as needed.
• Promote and educate on the use of MyChart.
• Create new patient records in the EHR, activate patients, and educate them on the benefits of MyChart.
• Complete the patient registration process and document in the EHR, including coverage types, guarantors, demographics, annual incomes, and other registration fields.
• Educate patients on FPL, Medicaid, and Marketplace requirements, as well as assist with over-the-phone support when possible.
• Auditor of patient charts to ensure accurate financial registration and reach out to patients to get updated and corrected information for accurate financial registration.
• Work with billing and site supervisors to coordinate needed paperwork and forms for patients.
• Manage basket messages related to registration updates, Medicaid eligibility, and sliding scale eligibility.

Requirements

• Working knowledge of health insurance plans including Medicaid and Medicare.
• Excellent oral and written communication skills, including effective communication with patients on complex or technical information regarding insurance coverage.
• Ability to develop and present effective presentations in different location settings and group sizes.
• Ability to prepare basic correspondence and simple reports in Microsoft Word and Excel.
• Ability to create, send, and manage emails in Outlook.
• Understanding of healthcare navigation including insurance types, concepts, terminology, billing, and/or regulations required.
• Knowledge of standard office policies and procedures.
• Knowledge of Microsoft Office software products preferred.
• Training in Marketplace enrollment preferred.
• Knowledge of standard office machines including copier, fax, shredder, multi-line telephone, printers, etc.
• Excellent customer service skills and ability to effectively and respectfully handle dissatisfied patients.
• Bi-lingual in Spanish/English strongly preferred.

Qualifications

• High school diploma or equivalent.
• Experience in healthcare administration, insurance, or a related field.
• Strong organizational and time management skills.
• Ability to work independently and as part of a team.
• Proficiency in Microsoft Office and familiarity with electronic medical records (EMR) systems.

Skills

• Working knowledge of health insurance plans including Medicaid and Medicare.
• Excellent oral and written communication skills, including effective communication with patients on complex or technical information regarding insurance coverage.
• Ability to develop and present effective presentations in different location settings and group sizes.
• Ability to prepare basic correspondence and simple reports in Microsoft Word and Excel.
• Ability to create, send, and manage emails in Outlook.
• Understanding of healthcare navigation including insurance types, concepts, terminology, billing, and/or regulations required.
• Knowledge of standard office policies and procedures.
• Knowledge of Microsoft Office software products preferred.
• Training in Marketplace enrollment preferred.
• Knowledge of standard office machines including copier, fax, shredder, multi-line telephone, printers, etc.
• Excellent customer service skills and ability to effectively and respectfully handle dissatisfied patients.
• Bi-lingual in Spanish/English strongly preferred.

Benefits

Mosaic Community Health offers a comprehensive benefits package that includes:

• Health insurance
• Dental insurance
• Vision insurance
• Paid time off
• Flexible spending accounts
• Retirement plan
• Employee assistance program

Pay

The salary range for this position is $45,000 - $60,000 annually, depending on experience and qualifications.

Schedule

This is a full-time position with flexible hours to accommodate the needs of the patient population and the community.