Provider Enrollment Follow-up Specialist Job at Randstad (Chennai)

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

Provider Enrollment Specialist

The Provider Enrollment Specialist ensures seamless plan enrollment (initial and...

Location

United States , St. Louis

Salary:

21.00 - 27.00 USD / Hour

Anders Minkler Huber & Helm LLP

Expiration Date

Until further notice

Requirements

Associate degree, preferred
High School diploma or GED required
3-5 years of experience in payer enrollment
Strong organizational and time management skills, with the ability to manage multiple tasks and meet deadlines
Excellent attention to detail and accuracy in data entry and record-keeping
Effective communication skills, both written and verbal, with the ability to interact professionally with providers, staff and external entities
Ability to work independently and as part of a team, demonstrating flexibility and adaptability
Strong problem-solving skills, with the ability to identify and resolve issues promptly and effectively
Knowledge of healthcare regulations and compliance requirements
Familiarity with NCQA, URAC, and CMS standards

Job Responsibility

Process and submit initial provider applications, revalidations, and renewal applications in compliance with NCQA, URAC, and CMS accreditation standards
Perform thorough and accurate data entry and verification of provider information into credentialing databases
Conduct timely follow-up on missing or incomplete information with the provider, client, or team lead responsible for a provider file to ensure prompt and efficient provider enrollment
Assist in the preparation and submission of required documentation for provider enrollment and credentialing to include delegation rosters
Coordinate with internal staff and external entities to resolve issues related to provider enrollment and credentialing
Monitor and track the status of provider applications, payer directories, conducting regular follow-up with health plans until verification of completion is received from each payor
Support the enrollment and delegation team with various tasks as needed

What we offer

Work Flex program which gives you the opportunity to work at our Chesterfield office, our Downtown St. Louis office, remotely, adopt a hybrid approach or even switch between these options as you prefer
Professional development opportunities
Benefits that directly impact mental, physical and financial wellness

Fulltime

Credentialing Enrollment Specialist

Location

United States , Charlotte

Salary:

24.10 - 36.15 USD / Hour

Advocate Health Care

Expiration Date

Until further notice

Requirements

High school diploma or GED required
Bachelor's degree preferred
Three years' experience in a role that performs or supports provider credentialing, privileging, and/or enrollment in either a hospital, managed care plan or CMS environment
Knowledge of and experience with personal computers, Windows and Microsoft applications, copier and fax machines and multi-line telephone
Experience in typing, word processing, and business correspondence
Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred

Job Responsibility

Performs primary source verifications of documentation required for managed care credentialing and re-credentialing of MGD providers
Provides issue resolution and support regarding billing issues as they relate to provider enrollment and credentialing for MGD providers and the Central Billing Office
Enters provider data in the ECHO database according to established departmental processes and provides feedback to other System entities as to the status of the applicants
Performs follow-up on needed information (expired licenses, board certifications insurance and DEA registrations) on an ongoing basis and ensures receipt of same in a timely manner
Prepares physician files for file audits by managed care organizations, Corporate Compliance and accreditation entities
Conducts practice site visits for practices within MGD
Facilitates communication tools and or activities to maintain timely and accurate flow of information to Managed Care Organizations (MCOs) and the System
Reviews hard copy and electronic provider directories and other information produced by managed care organizations reflecting MGD and the System's demographics and participation
Provides Team member support to the CPN Credentialing and Quality Review Committee

What we offer

Paid Time Off programs
Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
Flexible Spending Accounts for eligible health care and dependent care expenses
Family benefits such as adoption assistance and paid parental leave
Defined contribution retirement plans with employer match and other financial wellness programs
Educational Assistance Program

Fulltime

Benefits Specialist

We are looking for a Benefits Specialist to support benefits administration for ...

Location

United States , Fremont

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 4 years of experience in benefits administration or a closely related HR support function
Working knowledge of Medicare processes and familiarity with pension-related benefit programs
Proficiency with Excel, including maintaining trackers and managing detailed data accurately
Experience using HRIS or benefits systems to complete administrative tasks and review employee information
Prior experience with the required internal benefits platform
Workday exposure is preferred
Background in healthcare, hospital, or social assistance settings is preferred

Job Responsibility

Oversee the shared benefits mailbox and provide timely, accurate responses to employee questions involving enrollment periods and follow-up benefit updates
Coordinate administrative support for benefits programs by tracking Medicare reimbursements, handling payment-related paperwork, and organizing supporting records
Assist with both advance and follow-up enrollment activities, including entering information into internal systems and preparing employee communications
Maintain detailed Excel trackers to monitor benefit-related activity, status updates, and required follow-through
Use HR and benefits platforms to complete routine transactions, verify records, and support day-to-day program administration
Partner with HR team members to support onboarding and related benefit processes for employees as needed
Help ensure documentation is complete, current, and properly stored to support compliance and reporting needs
Process time-sensitive benefit invoices - weekly & monthly

What we offer

Medical, vision, dental, and life and disability insurance
Company 401(k) plan
Free online training

Fulltime

Benefits Specialist

We are looking for a Benefits Specialist to support benefits administration for ...

Location

United States , Fremont

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 4 years of experience in benefits administration or a closely related HR support function
Working knowledge of Medicare processes and familiarity with pension-related benefit programs
Proficiency with Excel, including maintaining trackers and managing detailed data accurately
Experience using HRIS or benefits systems to complete administrative tasks and review employee information
Prior experience with the required internal benefits platform

Job Responsibility

Oversee the shared benefits mailbox and provide timely, accurate responses to employee questions involving enrollment periods and follow-up benefit updates
Coordinate administrative support for benefits programs by tracking Medicare reimbursements, handling payment-related paperwork, and organizing supporting records
Assist with both advance and follow-up enrollment activities, including entering information into internal systems and preparing employee communications
Maintain detailed Excel trackers to monitor benefit-related activity, status updates, and required follow-through
Use HR and benefits platforms to complete routine transactions, verify records, and support day-to-day program administration
Partner with HR team members to support onboarding and related benefit processes for employees as needed
Help ensure documentation is complete, current, and properly stored to support compliance and reporting needs
Process time-sensitive benefit invoices - weekly & monthly

What we offer

medical
vision
dental
life and disability insurance
401(k) plan

Fulltime

Veteran Support Specialist

Location

United States , Springfield

Salary:

28.84 USD / Hour

Veterans Inc.

Expiration Date

Until further notice

Requirements

Bachelor's degree in Human Services, Social Work or related field. Masters Degree preferred. Military experience will be considered in lieu of a Bachelor's.
Minimum of three (3) years experience in case management, substance abuse prevention, outreach, and/or services to the homeless or veteran populations.
Demonstrated knowledge and experience in working with veterans preferred but not required
sensitivity to veterans-related needs and issues.
Comfort talking about and addressing the topic of suicide on a day-to-day basis.
Knowledge and compassion regarding suicide prevention.
Ability to communicate effectively with people from varied backgrounds, both orally and in writing.
Must be able to successfully pass a CORI/Background records check.
Compliance with Veterans Inc. COVID-19 Vaccination Policy. Religious and Medical Exemptions are considered.

Job Responsibility

Intake and assessment, problem identification, diagnosis, treatment planning and implementation, continuum of care, evaluation and follow-up.
Provides case management services to a caseload of veterans who are identified as high risk for suicide. This includes meeting with the veteran, developing individualized service plans, collaboration and coordination with programs within the VA, and connections to community based resources when appropriate.
Provides follow-up phone calls with Veterans who called the Veterans Crisis Line. The content of these calls can include clinical support, coordination with VA services, assistance enrolling in VA healthcare, providing community based resources, and support to family members of Veterans.
Provide suicide prevention consultation services and education on suicide prevention best practices to VA providers.

What we offer

BCBS Medical, Dental, and Vision Insurance
Employer Paid Short and Long-Term Disability and Life Insurance
$2500 Medical Opt-Out program if you have medical coverage through another source
Retirement Plan (403B) with a $2000 Match
Flexible Spending Accounts
Tuition Reimbursement Program
Paid Parental Leave

Fulltime

Outreach & Engagement Manager

Managing and motivating teams to drive enrollment. Drive enrollment and activati...

Location

United States

Salary:

90000.00 - 115000.00 USD / Year

Pomelo Care

Expiration Date

Until further notice

Requirements

Earned your Bachelor's degree in healthcare management, public health, or a related field
Able to work some evenings, with a standard schedule of Monday - Friday, 8:30am - 5:00pm CST
Proven experience in healthcare management, specifically in outbound calling and proactive outreach
Strong knowledge of Medicaid policies, procedures, and value-based care
Excellent communication and interpersonal skills to engage with diverse patient populations
Demonstrated leadership abilities, with experience in managing and motivating teams
Proficient in data analysis and reporting, using metrics to drive performance improvements
Detail-oriented, with exceptional organizational and documentation skills
Ability to adapt to changing priorities and work effectively in a fast-paced environment
Familiarity with healthcare software systems and customer relationship management (CRM) tools

Job Responsibility

Lead, and manage a team of outreach specialists providing regular training, and coaching to achieve enrollment KPIs
Facilitate onboarding and training of new specialists
Analyze qualitative and quantitative outreach performance metrics to identify trends and opportunities to improve key KPIs including enrollments and CAC
Monitor call quality and adherence to established protocols and standards by conducting regular audits of call recordings and specialist interactions
Maintain accurate and up-to-date documentation of specialist interactions, outcomes, and follow-up actions, adhering to privacy and confidentiality regulations
Identify opportunities and implement process improvements to enhance the efficiency and effectiveness of outbound and inbound calling
Execute on regular performance evaluations of outreach specialist calls and documentation
Create and maintain team schedules to ensure adequate coverage
Ensure compliance with government regulations and guidelines in all outbound calling and outreach activities
Foster a supportive and inclusive team environment, encouraging professional growth and development

What we offer

Competitive healthcare benefits
Generous equity compensation
Unlimited vacation
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)

Fulltime

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Provider Enrollment Follow-up Specialist

Job Description

Job Responsibility

Requirements

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