Job Description
Duration: 12 Months
Summary:
- Enrollment functions: Reviews enrollment details and effective dates to ensure accuracy prior
- to enrolling member. Works with team members to determine appropriate program enrollment.
- Enters, deletes, and revises enrollment related actions in interchange.
- Assists in the redetermination process and submits lists of all members to be renewed to appropriate external partners.
- Disenrollment functions: Reviews and processes all requested and approved disenrollments, whether voluntary or involuntary, for the members in an accurate and timely manner.
- Ensure effective dates are accurate and research discrepancies related to effective dates, preventing eligibility issues for members, providers, and MCOs.
Minimum Qualifications:
- Graduation from an accredited college or university with a bachelor’s degree or graduation from an accredited college or university with an associate’s degree and two years of qualifying professional experience
- Excellent verbal and written communications skills
- Proven technical skills (e.g. Microsoft Word, Excel, Outlook, PowerPoint, SharePoint, etc.)
- Excellent time management skills and ability to multi-task and prioritize work in order to meet specific timeframes and deadlines with minimal supervision
- Keen attention to detail and adherence to deadlines
- Organization
- Self-motivated and able to thrive in a fast-paced and results-driven environment
- Critical thinking and problem-solving skills