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

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

Enrollment Specialist

We are looking for an Enrollment Specialist to support client access to healthca...

Location

United States , Santa Barbara

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience supporting enrollment, annual enrollment, or open enrollment activities in a healthcare or human services setting
Knowledge of eligibility verification, benefits coordination, and documentation practices related to client service programs
Ability to review case notes and service records for accuracy, completeness, and alignment with program or billing standards
Strong computer data entry skills with the ability to maintain organized and reliable records in electronic systems
Familiarity with health care terminology, client support processes, and reimbursement-focused documentation standards
Effective communication skills and the ability to work collaboratively with case managers, service staff, and external partners
Strong attention to detail and the ability to manage multiple deadlines involving enrollments, authorizations, and follow-up tasks.

Job Responsibility

Guide eligible clients through enrollment into programs, completing and processing required forms accurately and on time
Partner with homeless services teams to monitor ongoing client eligibility, update records, and help prevent interruptions in approved coverage or support
Examine case management documentation to confirm services are properly recorded, clinically appropriate, and aligned with reimbursement standards
Coordinate with program and case management staff to track authorization timelines and support timely submission of renewal requests before expiration
Review claims-related records and supporting documentation in the Health Management Information System to promote accurate billing and complete file maintenance
Participate in meetings with internal teams and external partners to address service quality, operational needs, and continuous improvement efforts
Provide additional administrative and program support as needed to assist with successful day-to-day execution of CalAIM initiatives

What we offer

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

Part-Time Bilingual Spanish Insurance Enrollment Specialist

A Healthcare Company is seeking a Part-Time Bilingual Spanish Insurance Enrollme...

Location

United States , Buena Park

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

1+ year of experience in one or more of the following areas: Medical front desk, Patient access, Insurance enrollment
Strong communication and customer service skills
Detail-oriented with the ability to manage high-volume workflows
Strong organizational skills and ability to maintain accurate records
Basic computer proficiency and data entry skills
Bilingual in Spanish and English required

Job Responsibility

Guide patients through Covered California and Medi-Cal enrollment processes
Assist patients with applications, eligibility verification, and plan selection
Educate patients on insurance options, benefits, and coverage details in a clear and supportive manner
Verify documentation and ensure accuracy and completeness of all enrollment records
Provide in-person and phone support to patients with questions related to enrollment and coverage
Track enrollment activity and maintain accurate records in internal systems
Conduct follow-up with patients regarding renewals, missing documents, and incomplete applications
Support outreach efforts and community enrollment initiatives as needed
Collaborate with internal staff to help resolve enrollment issues and ensure a positive patient experience

What we offer

Medical Insurance
Dental Insurance
Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Parttime

Enrollment Specialist

A Health Plan in Buena Park for a Part Time Enrollment Specialist who is Bilingu...

Location

United States , Buena Park

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Bilingual in Spanish is a MUST
At least 1 year of experience in medical front desk, patient access, or insurance enrollment roles
Familiarity with health insurance programs such as Covered California and Medi-Cal is preferred
Strong communication and interpersonal skills to assist diverse patient populations
High attention to detail and the ability to manage multiple tasks efficiently in a fast-paced environment
Proficiency in computer data entry and maintaining organized records
Bilingual Spanish skills are preferred and may be required depending on client needs
Experience with annual and open enrollment processes is an advantage
Strong commitment to providing exceptional customer service.

Job Responsibility

Assist patients in completing applications and verifying their eligibility for health insurance programs, including Covered California and Medi-Cal
Provide clear explanations of insurance options, benefits, and coverage to help patients make informed decisions
Ensure all enrollment records are accurate by verifying documentation and resolving discrepancies
Maintain up-to-date records of enrollment activity and manage data entry into internal systems
Conduct follow-ups with patients to finalize incomplete applications or handle renewal processes
Collaborate with community outreach teams to support enrollment initiatives and drive awareness
Deliver excellent customer service by addressing patient inquiries and concerns promptly
Stay informed about changes in health insurance policies to provide accurate guidance to patients.

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement

Parttime

Enrollment Specialist

We are looking for a dedicated Enrollment Specialist to join our team in Buena P...

Location

United States , Buena Park

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 1 year of experience in medical front desk, patient access, or insurance enrollment roles
Familiarity with health insurance programs such as Covered California and Medi-Cal is preferred
Strong communication and interpersonal skills to assist diverse patient populations
High attention to detail and the ability to manage multiple tasks efficiently in a fast-paced environment
Proficiency in computer data entry and maintaining organized records
Bilingual Spanish skills are preferred and may be required depending on client needs
Experience with annual and open enrollment processes is an advantage
Strong commitment to providing exceptional customer service.

Job Responsibility

Assist patients in completing applications and verifying their eligibility for health insurance programs, including Covered California and Medi-Cal
Provide clear explanations of insurance options, benefits, and coverage to help patients make informed decisions
Ensure all enrollment records are accurate by verifying documentation and resolving discrepancies
Maintain up-to-date records of enrollment activity and manage data entry into internal systems
Conduct follow-ups with patients to finalize incomplete applications or handle renewal processes
Collaborate with community outreach teams to support enrollment initiatives and drive awareness
Deliver excellent customer service by addressing patient inquiries and concerns promptly
Stay informed about changes in health insurance policies to provide accurate guidance to patients.

What we offer

Medical, Dental and Vision Insurance
401K Retirement
Sick Time Off
Tuition Reimbursement.

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

Eligibility Specialist

Location

United States , Port Saint Lucie

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Experience working with Medicaid eligibility, insurance follow-up, or related healthcare benefits processes
Knowledge of documentation standards and timelines associated with public assistance or child welfare eligibility programs
Ability to manage multiple cases while maintaining strong attention to detail and accuracy
Proficiency in Microsoft Excel and general computer-based case or records management systems
Strong written and verbal communication skills for working with case managers, caregivers, and internal support teams
Ability to handle sensitive information with professionalism and confidentiality

Job Responsibility

Gather and organize records needed to complete Title IV-E eligibility reviews for children entering out-of-home care at the time of removal
Submit Medicaid applications for children placed in care and ensure each request is filed within required turnaround times
Enroll newly eligible children in the appropriate child welfare specialty Medicaid plan and confirm coverage setup is completed correctly
Identify cases that may qualify for Social Security-related benefits and route them to the appropriate trust or benefits specialist for follow-up
Prepare and process eligibility applications and redeterminations for children under supervision, maintaining active coverage without lapses
Review adoption-related eligibility files for completeness, maintain documentation, and coordinate with adoption case managers on approvals and finalization steps
Process adoption Title IV-E requests, update placement and service records, and manage related agreements as needed
Respond to questions from foster parents, caregivers, investigators, and case managers regarding Medicaid billing issues and primary care provider changes
Complete required system updates so the appropriate payee information is reflected accurately within designated Medicaid-related platforms

What we offer

Medical
vision
dental
life and disability insurance
401(k) plan
free online training

Fulltime

Member Services Specialist

We are looking for a detail-oriented Member Services specialist to join a team i...

Location

United States , Dayton

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

Previous experience in customer service, member services, or a similar administrative support role
Strong data entry skills with close attention to detail and a commitment to accuracy
Ability to manage inbound calls, email communication, and routine follow-up effectively
Working knowledge of Microsoft Word and Microsoft Excel for documentation and reporting tasks
Comfortable handling multiple responsibilities at once while meeting deadlines in a structured schedule
Experience processing records, updating account information, or supporting enrollment functions is preferred
Strong organizational skills and the ability to work effectively with internal teams, members, and vendors

Job Responsibility

Enter and update member information in the company portal with a high level of accuracy and confirm successful submissions
Process enrollment-related transactions and maintain eligibility records to support timely member service operations
Communicate with vendors and other external contacts when follow-up is needed to resolve account or service matters
Prepare, review, and distribute reports that help track membership activity and operational status
Scan, organize, and index documents so records remain accessible and properly maintained
Sort and distribute incoming mail to support efficient office workflow and service response times
Respond to inbound inquiries and email correspondence courteously while providing helpful customer support
Perform general administrative and order-entry tasks that contribute to smooth daily department operations

What we offer

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

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Provider Enrollment Follow-up Specialist

Job Description

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