Enrollment Specialist Job at Robert Half (Buena Park)

Provider Enrollment Specialist II - HP Enrollment Eligibility

Coordinates Medicare and Medicaid enrollment/re-enrollment and managed care cred...

Location

United States , Irving

Salary:

Not provided

CHRISTUS Health

Expiration Date

Until further notice

Requirements

High School Diploma
1-3 years of Payer Enrollment experience
Solid knowledge and utilization of PC applications to include WORD, EXCEL, ACCESS
Excellent written and verbal communication skills
Excellent organization and planning skills with demonstrated teamwork skills
Proven ability to interact with all levels of management and other Associates

Job Responsibility

Collects and maintains data on providers for Medicare and Medicaid enrollment
Prepares and submits applications to Medicare and Medicaid for new provider enrollments and existing provider updates
follows up by telephone or in writing, with carriers regarding application status
Complies with Medicare and Medicaid provider enrollment guidelines
Requests NPI numbers for providers and clinics as necessary and maintains NPI files
Follows up, either by telephone or in writing, with insurance companies and patients regarding the processing of outstanding claims and/or appeals
Generates various reports to identify outstanding claims issues with provider numbers and non-payment
Communicates information to appropriate personnel
Educates staff on corrections, e.g.. front-end entry errors in a positive, constructive manner
Collects and reviews managed care contracts for correct billing and payment terms

Fulltime

Outbound Enrollment Specialist

As an Outbound Enrollment Representative, you will be responsible for making out...

Location

United States

Salary:

40000.00 - 50000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

Ability to work Monday-Friday, 8:30am - 5:00pm CT
Strong, empathetic communication skills
Motivated by goals, metrics, and monthly bonus program
Passionate about changing the current landscape of healthcare
Strong organizational and time-management skills
Ability to work independently and as part of a team
Willing to work occasional overtime hours
Are internet-connected, able to work remotely

Job Responsibility

Conduct high volume outbound calls to patients to provide information and education about Pomelo Care services and resources
Achieve member enrollment goals as driven by company KPIs
Support patients by answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs
Document all interactions and maintain timely, accurate records of patient outreach activities
Collaborate internally and externally with healthcare providers, community organizations, and other stakeholders to ensure patients receive appropriate care and services
Work with families to schedule appointments and follow-up care as needed
Participate in training and development opportunities to stay current on healthcare trends and regulations
Manage inbound calls from potential patients

What we offer

Competitive healthcare benefits
Generous vacation policy
Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
Uncapped performance bonus paid out monthly

Fulltime

Bilingual Outbound Enrollment Specialist

As an Outbound Enrollment Representative, you will be responsible for making out...

Location

United States

Salary:

45000.00 - 55000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

Ability to work Monday-Friday, 8:30am - 5:00pm CT
Fluent in Spanish and English
Strong, empathetic communication skills
Motivated by goals, metrics, and monthly bonus program
Passionate about changing the current landscape of healthcare
Strong organizational and time-management skills
Ability to work independently and as part of a team
Willing to work occasional overtime hours
Are internet-connected, able to work remotely

Job Responsibility

Conduct high volume outbound calls to patients to provide information and education about Pomelo Care services and resources
Achieve member enrollment goals as driven by company KPIs
Support patients by answering their questions, addressing their concerns, and providing guidance on how Pomelo can support their needs
Document all interactions and maintain timely, accurate records of patient outreach activities
Collaborate internally and externally with healthcare providers, community organizations, and other stakeholders to ensure patients receive appropriate care and services
Work with families to schedule appointments and follow-up care as needed
Participate in training and development opportunities to stay current on healthcare trends and regulations
Manage inbound calls from potential patients

What we offer

Competitive healthcare benefits
Generous vacation policy
Membership in the First Round Network (a curated and confidential community with events, guides, thousands of Q&A questions, and opportunities for 1-1 mentorship)
Uncapped performance bonus paid out monthly

Fulltime

Manager of Enrollment Services

Westside Family Healthcare is a nonprofit organization that provides high qualit...

Location

United States , Bear

Salary:

Not provided

Westside Family Healthcare Inc

Expiration Date

Until further notice

Requirements

High school diploma or GED
Three or more years of experience working in healthcare, community relations or health insurance
Two or more years of experience with providing application and enrollment assistance for state and federal healthcare programs such as Medicaid, Screening for Life and the Health Insurance Marketplace
Experience managing employees in remote locations
Public speaking experience with the ability and willingness to speak at public events
Proficient in Microsoft Outlook, Word, Excel and PowerPoint with three or more years of experience
Valid driver’s license, reliable transportation and ability to travel independently between work locations
Willingness to submit to a criminal background check in accordance with
Three letters of reference from members of the community

Job Responsibility

Supervision and HR Management: Directly supervise the Assistance Manager of Enrollment Services, the Community Navigator Supervisor, and the team of Enrollment Specialists
Collaborate with HR and Associate Director of Enrollment Services for the recruitment, screening, hiring, training, and performance management of staff
Provide ongoing performance feedback, conduct formal evaluations, implement corrective actions, and manage employment terminations when necessary
Conduct weekly and quarterly one-on-one staff check-ins with staff
Grant Management and Resource Allocation: Work closely with the Associate Director of Enrollment Services and Director of External Affairs to meet grant deliverables
Effectively manage resources to support outreach and in-reach activities
Assistance to Patients and Consumers: Maintain federal navigator certification
Provide assistance to individuals in financial support for health care services, including through the Health Insurance Marketplace
Staff Education and Internal Referral System: Maintain expert-level knowledge of all state and federal programs and relay that information to staff
Collaborate with the Lead Enrollment Specialist and the Associate Director of Enrollment Services to develop and deliver monthly and as needed training sessions for Enrollment Services staff

What we offer

medical insurance
dental insurance
vision insurance
life and disability insurance
a 401(k) retirement plan with a match
supplemental insurances
generous PTO package
flexibility to provide work/life balance

Fulltime

Brand Sales Specialist Intern

Technology sales at IBM is evolving its way of working to break beyond boundarie...

Location

United States , Brookhaven, RESEARCH TRIANGLE PARK, Dallas, Austin, San Francisco, Costa Mesa, WASHINGTON, Cambridge, Chicago, New York

Salary:

72000.00 - 132000.00 USD / Year

IBM Deutschland GmbH

Expiration Date

Until further notice

Requirements

Actively Enrolled: Registered undergraduate or graduate university student
Technical Education: Seeking B.S. or M.S degree in Business/Communications with a STEM minor, Computer Science, Engineering, Information Systems, or similar technical disciplines
Client Focused: Asks open-ended questions and understands needs to address business challenges
Tech Savvy: Conversant about technology, latest industry trends and how it is being applied to address business challenges
Team Player: Demonstrates team collaboration and can navigate different communication styles
Excellent Communication Skills: Possess verbal, written, and interpersonal skills that are engaging, compelling and influential
Self-Starter: Motivated to work with clients and can lead projects independently
Confidence to contact and engage potential new customers and deliver an elevated experience
Motivation to achieve sales, business objectives and high client satisfaction
Aptitude to utilize selling technologies to network, engage clients, and identify new business opportunities

Job Responsibility

Sales Prospecting: Apply IBM’s sales methodology to identify new clients and opportunities for expansion with existing clients through multiple channels (email, phone, video creation, social media) - this includes a considerable amount of cold calling
Building Credibility and Trust: Through consultative methods at all levels, both internally and externally, to facilitate the closure of highly complex deals
Solution-Selling Expertise in Business Development: Apply solution-selling skills to identify and engage decision makers and influencers, assess business opportunities, and address clients' requirements to establish enduring, strategic partnerships
End-to-End Sales Process Management: Assist with the complete sales process, encompassing RFI/RFP response preparation and ensure the attainment of KPIs, with a notable emphasis on new business sales, while also extending services to existing accounts
Collaboration Across IBM Sales Ecosystem: Collaborate with the broader IBM sales ecosystem, from Marketing to Sales and technical colleagues, as well as IBM Business Partners, to formulate sales campaigns and augment the pipeline

What we offer

Supplemental 1 employees may be eligible for up to 8 paid holidays, minimum of 56 hours paid sick time and the IBM Employee Stock Purchase Plan
IBM offers paid family medical leave and disability benefits to eligible employees where required by applicable law

Fulltime

Entitlement Advocate

The Entitlement Advocate provides Healthfirst Medicare Advantage Plan(MAP), Mana...

Location

United States

Salary:

48600.00 - 65960.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

High school diploma or GED from an accredited institution
Member facing or customer service experience
Be able to work 9am-5:30pm schedule
Be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County
Capability to work in a Hybrid Schedule (remote/office/field)
Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint
Bilingual
Be able to communicate and engage with the leadership team on virtual platforms such as Zoom or Microsoft Teams chat as well as in person

Job Responsibility

Handle inbound and outbound calls to and from customers to address their needs while adhering to our service level goals
Screen all incoming calls and handles accordingly
Transfer calls to appropriate staff, unit, or department
Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New Medicaid Applications
Outreach Senior Health Partners, CompleteCare, and Life Improvement Plan members according to approved scripts
Research ePACES and/or Marx for Medicaid and Medicare eligibility, exclusion, and exemption codes
Consult with HRA Medicaid staff as needed and report to supervisor any need for HRA consultation
Document all client calls /outcomes in database systems
Schedule appointments to see members/prospects out in the field to assist with Medicaid Issue or restriction code removals or demographic information changes
Educate potential members on Senior Health Partners, Long term care plan benefits answering questions regarding plan’s features and benefits as well as go through eligibility and requirement for enrollment

What we offer

medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions

Fulltime

Entitlement advocate

The Enrollment Medicaid Specialists provides Healthfirst’ s Medicare Advantage P...

Location

United States , New York

Salary:

48600.00 - 65960.00 USD / Year

Healthfirst

Expiration Date

Until further notice

Requirements

High school diploma or GED from an accredited institution
Member facing or customer service experience
Be able to work 9am-5:30pm schedule
Be able to travel throughout the 5 boroughs, Westchester, Orange, Sullivan, Rockland, and Nassau County
Capability to work in a Hybrid Schedule (remote/office/field)
Tech Savvy computer skills such as Microsoft Office Suites: Outlook, Excel, Word, PowerPoint
Bilingual
Be able to communicate and engage with the leadership team on virtual platforms such as Zoom or Microsoft Teams chat as well as in person

Job Responsibility

Handle inbound and outbound calls to and from customers to address their needs while adhering to our service level goals
Screen all incoming calls and handles accordingly
Transfer calls to appropriate staff, unit, or department
Assist callers requesting assistance with Medicaid Renewal application, Medicare Savings Program application, and New Medicaid Applications
Outreach Senior Health Partners, CompleteCare, and Life Improvement Plan members according to approved scripts
Research ePACES and/or Marx for Medicaid and Medicare eligibility, exclusion, and exemption codes
Consult with HRA Medicaid staff as needed and report to supervisor any need for HRA consultation
Document all client calls /outcomes in database systems
Schedule appointments to see members/prospects out in the field to assist with Medicaid Issue or restriction code removals or demographic information changes
Educate potential members on Senior Health Partners, Long term care plan benefits answering questions regarding plan’s features and benefits as well as go through eligibility and requirement for enrollment

What we offer

medical, dental and vision coverage, incentive and recognition programs, life insurance, and 401k contributions

Fulltime