Managed Care Enrollment Specialist

Position Highlights

• $18.47-$22.62/hour DOE with the ability to go higher for highly experienced candidates
• 100% employer-paid health insurance including medical, dental, vision, Rx, and 24/7 telemedicine
• Profit sharing & 403(b) retirement plan available
• Generous PTO, 8 paid holidays, and much more!

What You’ll Do

• Work directly with a patient to enroll and maintain healthcare coverage
• Complete an Affordable Care Act (ACA) application, a Medicaid renewal, and other required updates
• Identify an eligibility problem and perform appropriate research, documentation, and follow-through to find a solution
• Perform outreach to get a new patient. Coordinate their appointment to establish care with a Provider in the clinic
• Provide education regarding the ACA to current and prospective members
• Process a referral and respond to a customer inquiry
• Explain benefits, procedures, and protocols to an external and internal customer
• Submit the required documentation to a Managed Care plan for a plan-approved referral
• Manage work to meet or exceed a goal for response time and quality for the call center
• Perform other duties as assigned

Qualifications

• A High School Diploma or GED required; Associate of Arts Degree in business or a similar field is preferred
• One year of experience interacting with the public in a business environment is required
• One year of experience working in a healthcare environment with experience in healthcare information systems is preferred
• Certified ACA navigator or completion of ACA training and certification is required within 90 days of employment
• Bilingual (English/Spanish) required at a level 10
• Knowledge of health care systems is highly desirable
• Knowledgeable in the use of standard office equipment
• Ability to manage stressful situations and work in a fast-paced and rapidly changing environment