Enrollment Representative

Posted · Add Comment

APPLY NOW

  • 18-00246
  • Full Time/Contract
  • Operations
  • Tustin, CA
Job Description
CLIENT COMPANY OVERVIEW
Our client is a is a nonprofit integrated delivery system that includes multiple top hospitals, health plans and freestanding ambulatory surgery centers in Orange and Los Angeles Counties. An innovator in healthcare delivery, our client focuses on evidence-based, best practice medicine and has gained widespread recognition for their approach in healthcare.

POSITION TITLE & LOCATION
Enrollment Associate
(open enrollment)

Tustin, CA
POSITION SUMMARY

  • Manage personal queue, issues and tickets in ServiceNow and Workfront: Complete documentation, contract information and follow-up communication once issue is resolved.
  • Maintain regular user contact and attend relevant meetings, and assists with contact for IS to ensure communication, collaboration, and teamwork.
  • Identify and resolve problems and issues that arise in the application.
  • Develops and maintains an ongoing awareness of healthcare information systems initiatives, emerging technologies, and relevant laws and regulations in providing ongoing and competent support for assigned areas of responsibility.
  • Complies with all IS Policies, Procedures and Standards including: Project Management tools/methodologies, Network/Systems Workstation Security, HIPAA Privacy and Security Regulations associated with Electronic Protected Health Information (ePHI).
  • Accurately update member eligibility information by verifying eligibility and benefit information using the various health plan websites. When necessary, communicate with the health plans by asking appropriate questions and being familiar with the terminology used. Effectively navigate through the system of record application to enroll these members.
  • Resolve routine problems and issues associated with assigned applications to ensure high levels of availability and user satisfaction. Maintain contact with users and senior team members to ensure understanding of needs, assignments, and overall goals.
  • Adheres to department productivity goal in managing personal queue, issues and tickets in Service Now and Work Front, etc. within the established service level agreement.
  • Maintains flexibility to undertake new assignments as required to react quickly and positively to changing priorities including but not limited to member demographics update, expired patient, shell coverage clean-up, dual coverage clean-up, Hospice report, and ERISA report.
  • Work as a team player and communicates in a positive manner with co-workers, managers and other contacts in regards to best practices.
  • Prioritize work to meet department deadlines and the needs of other departments. Keep supervisor/manager informed of issues pertaining to enrollment.
  • Participates in education programs, in-service meetings and workshops to enhance professional growth and development.
  • Participates in regular meetings with users and decision makers to ensure operational approval for all system initiatives.


QUALIFICATIONS / REQUIREMENTS

  • A minimum of one (1) year experience in a business office environment preferred.
  • Must possess strong 10-key skills.
  • Accurate data entry or typing skills necessary.
  • Experience in reviewing and updating HMO managed care eligibility.
  • General knowledge of managed care insurance and basic computer skills also required.
  • Good written and verbal communication skill
  • EPIC experience preferred

COMPENSATION
$18.00/hr

Schedule:
Monday Friday (8a 4:30pm)



Apply

Your Details

Please fill in the form below to send us brief details about you. We will use this information to get in touch to process your application in full.

Basic Details

First Name*

Last Name*

Contact Information

Email Address*

Phone Number

Mobile Phone Number

Supporting Comments

Please provide a short summary in support of your application for this vacancy.

Message

Attach Resume

Please attach a copy of your CV (.doc, .docx, .pdf)