Our client in the Healthcare Industry, located in Somerville, MA, is looking to hire a Member Enrollment Representative to join their growing team, on a temporary basis. As part of the Member Enrollment Team, you will be responsible for the enrollment tasks for Commercial and MassHealth/Medicaid members including the entry of information into company's enrollment system and working with reports to resolve discrepancy issues.
The position starts in January, and is actively interviewing candidates now. Reply with your resumes and we'll get in touch.
Learn Medicare/Medicaid and Commercial enrollment processes and guidelines.
Enter enrollments, disenrollments, and changes into the eligibility system.
Prioritize work per financial impact.
Work with Commercial Staff and other team members to resolve eligibility issues.
Communicate with Customer Service and Claims on urgent issues.
Work with Clinical for processing and reconciling enrollment issues for MH new born babies
Learn and process HFI, CMA, MH reconciliations and discrepancies, Weekly and monthly MH discrepancy reports, Research discrepancies for a response to MH e-mails
Assist with pharmacy, site, and PCP activities that impact enrollment.
Efficiently navigating multiple systems to Research and correct errors found on discrepancy reports or E-mail.
Meet Standards for Accuracy and Quality goals
Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect.
Work with other departments and outside partners to provide the best resolution for the customer
Sense of urgency and strong communication skills on the phone, in person and via email.
Strong data entry skills and data interpretation knowledge.
Ability to read reports and take note of trends.
Highly organized, with excellent written and verbal communication skills
The candidate must be able to multi-task, prioritize projects and work independently as well as effectively within a team environment
Proficient typing (25 wpm)
Excellent grammar skills
Data Entry, problem solving, ability to meet quality and quantity standards.