Enrollment Coordinator

2 weeks ago(11/28/2017 12:36 PM)
Requisition ID
2017-2662
# of Openings
1
Area of Interest
Social Work
Company
Elderwood
Elderwood Administrative Services
Position Type
Regular Full-Time

Overview

The primary purpose of the Enrollment Coordinator is to provide assistance to potential members and facilitate plan membership. The Enrollment Coordinator will also monitor applications submitted to the Local Departments of Social Services (LDSS) and Maximus, track progress and report on any challenges. The Enrollment Coordinator will screen new candidates and identify eligible potentials related to both long-term care needs and Medicaid coverage for enrollment. This includes but is not limited to providing potential members and their families with education regarding the MLTC model of care.

Responsibilities

  • Answer product and/or service questions.
  • Complete all necessary paperwork, documentation, and follow-up as required (i.e. enrollment application, lead reports, outreach logs, scheduling and other administrative work).
  • Establish contact, assess individual's needs and concerns, establish eligibility, provide overview of organizational mission, effectively and clearly present benefits of products in accordance with all Governmental regulations.
  • Conduct individual client screening to assess for Medicaid funded Long Term Care eligibility, follow-up with State Brokers to ensure proper handling of the Medicaid MLTC application process, and facilitate Conflict Free Enrollment Center appointments for evaluations for MLTC enrollment.
  • Assist with the screening of candidates toward identification of qualified, eligible potentials related to both long-term care needs and Medicaid coverage for enrollment
  • Provide potential members and their families with education regarding the MLTC model of care.
  • Help process calls from interested parties for potential enrollees.
  • Complete pre-enrollment screening form for all potential enrollees.
  • Work with EMR and State Electronic Systems for new enrollment management
  • Assist Social Work Care Manager with enrollment responsibilities
  • Educate potential enrollees on the plan benefits and provider network.
  • Tracks all enrollment and disenrollment information and communicates with EHP billing department.
  • Ensures that all enrollment and disenrollment activities are documented accurately in the member electronic health record.
  • Communicates with RN Care Managers and outside vendors regarding scheduling of initial UAS assessment.
  • Submission of all potential enrollments/disenrollments to the New York State broker MAXIMUS.
  • Other assigned duties as necessary

Qualifications

  • Associates degree required, Bachelors preferred
  • Valid NYS Driver’s Licence
  • Bilingual fluency in Spanish, preferred
  • Must be in good standing with the Medicare and Medicaid programs
  • Proficiency in Microsoft Office: Excel, Word, Access; Internet navigation, required
  • Excellent Communication
  • Ability to solve diverse problems that require interpretation of administrative and/or technical issues.
  • HIPAA Privacy compliance.

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