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Enrollment Specialist jobs at Beth Israel Lahey Health

- 643 jobs
  • Sr. Enrollment Specialist

    Beth Israel Lahey Health 3.1company rating

    Enrollment specialist job at Beth Israel Lahey Health

    **When you join the growing BILH team, you're not just taking a job, you're making a difference in people's lives.** Under the direction of the Manager, Provider Enrollment completes enrollment and health plan recredentialing applications. Maintains physician database and acts as a resource to providers, practice staff, BIDCO staff and health plan provider representatives concerning health care plan participation and status. Demonstrates competency in all aspects of the enrollment process and their assigned provider participation with over 25 affiliated health plans/ products, including Medicare and Medicaid. **Job Description:** **Primary Responsibilities:** **Facilitates timely enrollment of new providers in health plans and existing providers in newly contracted health care plans including compilation of confidential data . Maintains knowledge of NCQA standards and health plan enrollment and credentialing guidelines (including Medicare and Medicaid). (essential)** **Compiles accurate health plan application packets for the many different Members of BIDCO, keeping abreast of the numerous changes in application and licensure documentation. Reviews returned applications for accuracy and completeness prior to submission to the health plans. (essential)** **Performs recredentialing of BIDCO providers every 2 years so that providers may continue to bill for services rendered. Coordinates with departments to distribute recredentialing applications and reminders, tracking all providers to completion within anticipated target dates. (essential)** **Inputs enrollment information into the provider database at time of initial enrollment, and for any ongoing changes. Maintains accuracy and completeness of provider database in accordance with uniform nomenclature. (essential)** **Communicates directly with health plans, clinicians and BIDCO practice staff. Develops and implements reporting mechanisms to keep providers and administrators apprised of providers' health care plan status, working with them to ensure completion of enrollment with health plans within anticipated target date. (essential)** **Develops and maintains excellent working relationships with both provider practices and health plan contacts regarding provider enrollment statuses. Investigates and resolves enrollment problems with health plans that are impeding proper billing and reimbursement. (essential)** **Assist Administrator in the processing of applications with the health plans for new group entities coming into BIDCO. Ensure that proper documents are obtained from the groups, coordinate with local community hospitals to determine hospital privileges and obtain relevant documents, review pre-BIDCO plan status and coordinate with management the timing of new entities into BIDCO. (essential)** **Facilitate delegated credentialing process in coordination with affiliated Professional Staff Affairs offices. (essential)** **Required Qualifications:** **High School diploma or GED required. Bachelor's degree preferred.** **Year of experience 3-7** **Provider Enrollment experience is strongly preferred.** **Advanced skills with Microsoft applications which may include Outlook, Word, Excel, PowerPoint or Access and other web- based applications. May produce complex documents, perform analysis and maintain databases.** **Preferred Qualifications:** **1. Knowledge of Medicare, Medicaid and health plan credentialing, recredentialing and enrollment process; licensure requirements and regulations of various agencies such as the board of Registration in Medicine, American Board of Medical Specialties and Individual Specialty Boards preferred normally acquired through related work experience.** **Pay Range:** $25.00 - $38.00 The pay range listed for this position is the base hourly wage range the organization reasonably and in good faith expects to pay for this position at this time. Actual compensation is determined based on several factors, that may include seniority, education, training, relevant experience, relevant certifications, geography of work location, job responsibilities, or other applicable factors permissible by law. Compensation may exceed the base hourly rate depending on shift differentials, call pay, premium pay, overtime pay, and other additional pay practices, as applicable to the position and in accordance with the law. **As a health care organization, we have a responsibility to do everything in our power to care for and protect our patients, our colleagues and our communities. Beth Israel Lahey Health requires that all staff be vaccinated against influenza (flu) as a condition of employment.** **More than 35,000 people working together. Nurses, doctors, technicians, therapists, researchers, teachers and more, making a difference in patients' lives. Your skill and compassion can make us even stronger.** **Equal Opportunity Employer/Veterans/Disabled**
    $25 hourly 48d ago
  • ECMO Specialist I ($20,000 Sign On Bonus)

    Boston Children's Hospital 4.8company rating

    Boston, MA jobs

    The ECMO Specialist is enrolled and actively participating in the department's ECMO Training Program. This role is responsible for developing and maintaining the skills necessary to proficiently and safely establish, manage, and control extracorporeal membrane oxygenation (ECMO) technology and assist with associated procedures in acutely ill patients of all ages in critical care settings. The specialist will learn to troubleshoot devices and associated equipment under the supervision of experienced ECMO personnel, provide ongoing care through surveillance of clinical and physiologic parameters, adjust ECLS devices as needed, administer and document blood products and medications in accordance with hospital standards, provide airway and ventilator management, and perform the full scope of practice of a Respiratory Therapist II. Schedule: 36 hours per week, rotating day/night shifts, every third weekend. **This position is eligible for full time benefits $20,000 sign-on bonus (not eligible for internal candidates and not eligible for former BCH employees who worked here in the past 2 years) Key Responsibilities: Assemble, prepare, and maintain extracorporeal circuits and associated equipment with assistance. Assist in priming extracorporeal circuits and preparing systems for clinical application. Assist with cannulation procedures. Assist in establishing extracorporeal support; monitor patient response, provide routine assessments, circuit evaluations, patient monitoring, and anticoagulation management. Assist with ECMO circuit interventions, weaning procedures, and transports. Administer blood products per hospital standards. Interact and communicate with caregivers, nursing, surgical and medical teams, patients, and family members. Maintain relevant clinical documentation in the patient's electronic health record. Participate in professional development, simulation, and continuing education. Attend ECMO Team meetings and M&M conferences on a regular basis. Minimum Qualifications Education: Required: Associate's Degree in Respiratory Therapy Preferred: Bachelor's Degree Experience: Required: A minimum of one year of experience as a BCH Respiratory Therapist with eligibility for promotion to RT II, or one year of external ECMO experience Preferred: None specified Licensure / Certifications: Required: Current Massachusetts license as a Respiratory Therapist Required: Current credential by the National Board of Respiratory Care as a Registered Respiratory Therapist (RRT); Neonatal Pediatric Specialist (NPS) credential must be obtained within 6 months of entry into the role Preferred: None specified The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
    $67k-93k yearly est. 3d ago
  • Patient Benefits Coordinator - $19.58 - 23.98/hr

    Yakima Valley Farm Workers Clinic 4.1company rating

    Hermiston, OR jobs

    Join our team as a Patient Benefits Coordinator at Mirasol Family Health Center in Hermiston, OR! Be part of a healthcare organization that believes in making a difference beyond medical care! We've transformed into a leading community health center in the Pacific Northwest with 40+ clinics across Washington and Oregon. We offer a wide range of services such as medical, dental, pharmacy, orthodontia, nutritional counseling, autism screening, and behavioral health. Our holistic model also extends assistance to shelter, energy, weatherization, HIV and AIDS counseling, home visits, and mobile medical/dental clinics. Explore our short clips, " WE are Yakima - WE are Family " and " YVFWC - And then we grew ," for a glimpse into our dedication to our communities, health, and families. Visit our website at ************* to learn more about our organization. Position Highlights: $19.58-$23.98 DOE with the ability to go higher for highly experienced candidates 100% employer-paid health insurance including medical, dental, vision, Rx, and 24/7 telemedicine Profit sharing & 403(b) retirement plan available Generous PTO, 8 paid holidays, and much more! What You'll Do: Address patient billing inquiries and collaborate with the Billing and Medicaid Office for issue resolution Inform patients on billing and payment practices, provide account details and balance information Discuss medical insurance options, eligibility, and Managed Care plans with clients Assist clients with insurance application process, track applications, and provide guidance on benefits Educate clients on medical insurance coverage, help resolve card-related issues Manage daily work queues for insurance, discounts, and Medicaid processing Evaluate and process hardship or write-off requests, maintain billing adjustments Stay updated on Managed Care and Medicaid program changes and updates Qualifications: High School Diploma or General Education Diploma (GED) One year's experience with billing credit or patient benefits, preferably in a medical office, is required; Experience in special programs such as State Managed Care plans is preferred Affordable Care Act (ACA) Certification: Must pass the ACA exam within 90 days of employment Bilingual (English/Spanish) required at a level 9 Ability to prioritize work and handle various tasks simultaneously, with frequent interruptions Ability to build effective relationships and interact professionally with patients, providers, and staff Basic proficiency with Electronic Medical Records, Word, and Excel Basic knowledge of medical terminology and medical billing insurance is desired Our Mission Statement “Together we transform our communities through compassionate, individualized care, eliminating barriers to health and well-being.” Our mission celebrates inclusivity. We are committed to equal-opportunity employment. Contact us at ************** to learn more about this opportunity!
    $43k-54k yearly est. 2d ago
  • RCM OPEX Specialist

    Femwell Group Health 4.1company rating

    Miami, FL jobs

    The RCM OPEX Specialist plays a critical role in optimizing the financial performance of healthcare organizations by ensuring that revenue cycle management processes are efficient and compliant with industry regulations. This position requires detail-oriented professionals who can navigate complex insurance claims and reimbursement processes. Essential Job Functions Manage internal and external customer communications to maximize collections and reimbursements. Analyze revenue cycle data to identify trends and proactively remediate suboptimal processes. Maintain fee schedule uploads in financial and practice operating systems. Review and resolve escalations on denied and unpaid claims. Collaborate with healthcare providers, payors, and business partners to ensure revenue best practices are promoted. Monitor accounts receivable and expedite the recovery of outstanding payments. Prepare regular reports on refunds, under/over payments. Stay updated on changes in healthcare regulations and coding guidelines. *NOTE: The list of tasks is illustrative only and is not a comprehensive list of all functions and tasks performed by this position. Other Essential Tasks/Responsibilities/Abilities Must be consistent with Femwell's core values. Excellent verbal and written communication skills. Professional and tactful interpersonal skills with the ability to interact with a variety of personalities. Excellent organizational skills and attention to detail. Excellent time management skills with proven ability to meet deadlines and work under pressure. Ability to manage and prioritize multiple projects and tasks efficiently. Must demonstrate commitment to high professional ethical standards and a diverse workplace. Must have excellent listening skills. Must have the ability to maintain reasonably regular, punctual attendance consistent with the ADA, FMLA, and other federal, state, and local standards and organization attendance policies and procedures. Must maintain compliance with all personnel policies and procedures. Must be self-disciplined, organized, and able to effectively coordinate and collaborate with team members. Extremely proficient with Microsoft Office Suite or related software; as well as Excel, PPT, Internet, Cloud, Forums, Google, and other business tools required for this position. Education, Experience, Skills, and Requirements Bachelor's degree preferred. Minimum of 2 years of experience in medical billing, coding, revenue cycle or practice management. Strong knowledge of healthcare regulations and insurance processes. Knowledgeable in change control. Proficiency with healthcare billing software and electronic health records (EHR). Knowledge of HIPAA Security preferred. Hybrid rotation schedule and/or onsite as needed. Medical coding (ICD-10, CPT, HCPCS) Claims management (X12) Revenue cycle management Denials management Insurance verification Data analysis Compliance knowledge Comprehensive understanding of provider reimbursement methodologies Billing software proficiency
    $34k-49k yearly est. 5d ago
  • Enrollment Specialist (East Coast)

    Hello Heart 3.9company rating

    Remote

    Hello Heart is on a mission to change the way people care for their hearts. The company provides the first app and connected heart monitor to help people track and manage their heart health. With Hello Heart, users take steps to control their risk of heart attacks and stroke - the leading cause of death in the United States. Peer-reviewed studies have shown that high-risk users of Hello Heart have seen meaningful drops in blood pressure, cholesterol and even weight. Recognized as the digital leader in preventive heart health, Hello Heart is trusted by more than 130 leading Fortune 500 and government employers, national health plans, and labor organizations. Founded in 2013, Hello Heart has raised more than $138 million from top venture firms and is a best-in-class solution on the American Heart Association's Innovators' Network and CVS Health Point Solutions Management platform. Visit ****************** for more information. About The Role Our clients are seeing the immense value and health benefits for their employees and we're constantly getting new users, which means we're looking for an Enrollment Specialist to assist in enrolling our new users at events around the United States, with an emphasis on the East Coast. We are looking for someone who is currently based on the East Coast, preferably in the Northeast, near a major airport, as this role requires heavy travel around the country during our peak months. Hello Heart believes in every employee being taken care of from their toes to their heart and everything else! This is a salaried position, with full medical benefits paid (health, dental, vision), and equity in the company. Responsibilities: Create delightful member interactions, ensuring member experience is top of the line. Partner with Customer Success and our clients to design and execute successful enrollments and engagement campaigns, both virtually and in-person. Travel onsite to clients to drive users' enrollment process in different locations across the United States. Assist with Marketing and Customer Success teams with feedback on how to improve enrollment events, actively providing solutions and problem-solving. Own member questions live and on-site, and escalating more complex issues to our Support and Developer teams as needed. Qualifications: Bachelor's degree or equivalent work experience Currently located on the East Coast, strong preference for the Northeast, near a major airport 2+ years experience working a customer-facing position, ideally working in a field role or events role managing logistics Professional work experience in a travel-heavy role with the ability to travel at least 50% of the time seasonally Comfortable working at different hours of the day. (ie, split shifts, early mornings, late nights to accommodate enrollment schedules) Ability to lift up to 30 pounds A valid Driver's License Nice to have: Bilingual in Spanish, both conversationally and in writing The US base salary range for this full-time position is $65,000.00 to $75,000.00. Salary ranges are determined by role and level. Compensation is determined by additional factors, including job-related skills, experience, and relevant education or training. Please note that the compensation details listed in US role postings reflect the annual salary and bonus only, and do not include equity or benefits. Hello Heart has a positive, diverse, and supportive culture - we look for people who are collaborative, creative, and courageous. Oh, and if you want to see some recent evidence of the fun things we do at Hello Heart, check out our Instagram page.
    $65k-75k yearly Auto-Apply 2d ago
  • Payor Enrollment Specialist (SC/NC/GA Remote only)

    Ob Hospitalist Group Corporate 4.2company rating

    Greenville, SC jobs

    Join our Mission: Join the forefront of women's healthcare with OB Hospitalist Group (OBHG), the nation's largest and only dedicated provider of customized obstetric hospitalist programs. Celebrating over 19 years of pioneering excellence, OBHG has transformed the landscape of maternal health. Our mission-driven company offers a unique opportunity to elevate the standard of women's healthcare, providing 24/7 real-time triage and hospital-based obstetric coverage across the United States. If you are driven to join a team that makes a real difference in the lives of women and newborns and thrive in a collaborative environment that fosters innovation and excellence, OBHG is your next career destination! Payor Enrollment Specialist Position Summary: Processes credentialing and re-credentialing applications and Credentialing Vendor requests for OBHG health care providers. Preference for candidates residing SC, NC, and GA. Hourly Compensation: $21.00 - $24.00 (based on experience) Fully remote work, equipment provided. What We Offer - More of The Good Stuff: A mission based company with an amazing company culture. Paid time off & holidays so you can spend time with the people you love. Medical, dental, and vision insurance for you and your loved ones. Health Savings Account (with employer contribution) or Flexible Spending Account options. Paid Parental Leave Employer Paid Basic Life and AD&D Insurance. Employer Paid Short- and Long-Term Disability. Optional Short Term Disability Buy-up plan. 401(k) Savings Plan, with ROTH option. Legal Plan. Identity Theft Services. Mental health support and resources. Employee Referral program - join our team, bring your friends, and get paid. Payor Enrollment Specialist Responsibilities: Essential Maintain credentialing information by reviewing, entering and following up on missing Establish and maintain professional relationship with providers, insurance providers, client contacts and account service/credential Submit and follow up on request for signatures in a timely Respond to credentialing Contact and respond to request to/from hospitals and health payers for verification of provider's credentials, ensuring credentialing and licensing processes are completed Responsible for the processing and preparation of the applications for insurance payer participation with the ability to manage multiple facilities'/payers' enrollment requirements, which includes non-application requests that are indicated by OBHG staff and/or facility/payer. Track credentialing application Maintains providers/practitioner files including maintenance of the OBHG provider database, individual CAQH profiles and providers rosters by identifying who may need updating or re credentialing and process Maintains and updates CRM, Mail and Utility Logs for provider's licensure, board certifications and certificate of Escalate non-responsiveness of MD to Supervisor with documentation of Meet required turnaround times and accuracy Ensure all Protected Health Information is kept in a secure location at all times and maintain Compliance by communicating credentialing request, status and issues to the Corporate Compliance Participate in the credentialing committee as Perform other duties as assigned by Payer Enrollment Manager and/or Management Payor Enrollment Specialist Essential Skills/Credentials/Experience/Education Five years' experience in payor enrollment for Medicaid and Managed Care payors. Strong organizational skills and attention to A minimum of a High School Diploma or equivalent is required; some college or equivalent experience is preferred. Preferred Skills/Credentials/Experience/Education Strong telephone Strong computer skills, proficient in Word, Excel & Preferred understanding of medical CPCS credentialing Physical Demands (per ADA guidelines) Physical Demands: Sitting for long periods of Occupation requires this activity more than 66% of the time (2.6+ hrs/day) Travel Demands: May require occasional travel to corporate headquarters in Greenville, SC
    $21-24 hourly 60d+ ago
  • ON-SITE Credentialing and Enrollment Specialist

    Mendocino Community Health Clinic, Inc. 4.6company rating

    Ukiah, CA jobs

    In this vital role, you will be responsible for ensuring accurate and timely credentialing of healthcare professionals and managing their enrollment processes with various insurance payors. Your expertise will help maintain compliance and support our commitment to providing access to high-quality patient care. Key Responsibilities: * Verify and maintain the credentials of healthcare professionals, including licenses, certifications, and educational qualifications * Manage the enrollment process of healthcare providers with multiple payor insurance plans * Ensure timely submission of credentialing and re-credentialing applications * Communicate effectively with Credentialing Verification Organization, healthcare providers, insurance companies, and internal teams to resolve issues * Monitor and track credentialing and enrollment statuses to ensure compliance with regulatory requirements Skills and Qualifications: * Strong organizational and administrative skills with attention to detail * Excellent communication and interpersonal skills * Ability to manage multiple tasks and meet deadlines in a fast-paced environment * Proficiency in Microsoft Office Suite * Proven experience in healthcare credentialing and insurance enrollment preferred * Knowledge of healthcare regulations and payor requirements preferred We offer a collaborative work environment, opportunities for professional growth, and a comprehensive benefits package. Requirements Required: AA degree 1+ years' experience in a healthcare setting Preferred: Bachelor's degree in healthcare administration or related field 1+ years' experience in credentialing and enrollment Salary Description $26.00 - $36.00 per hour, DOE
    $26-36 hourly 60d+ ago
  • Enrollment Specialist (East Coast)

    Hello Heart 3.9company rating

    Menlo Park, CA jobs

    Hello Heart is on a mission to change the way people care for their hearts. The company provides the first app and connected heart monitor to help people track and manage their heart health. With Hello Heart, users take steps to control their risk of heart attacks and stroke - the leading cause of death in the United States. Peer-reviewed studies have shown that high-risk users of Hello Heart have seen meaningful drops in blood pressure, cholesterol and even weight. Recognized as the digital leader in preventive heart health, Hello Heart is trusted by more than 130 leading Fortune 500 and government employers, national health plans, and labor organizations. Founded in 2013, Hello Heart has raised more than $138 million from top venture firms and is a best-in-class solution on the American Heart Association's Innovators' Network and CVS Health Point Solutions Management platform. Visit ****************** for more information. About The Role Our clients are seeing the immense value and health benefits for their employees and we're constantly getting new users, which means we're looking for an Enrollment Specialist to assist in enrolling our new users at events around the United States, with an emphasis on the East Coast. We are looking for someone who is currently based on the East Coast, preferably in the Northeast, near a major airport, as this role requires heavy travel around the country during our peak months. Hello Heart believes in every employee being taken care of from their toes to their heart and everything else! This is a salaried position, with full medical benefits paid (health, dental, vision), and equity in the company. Responsibilities: Create delightful member interactions, ensuring member experience is top of the line. Partner with Customer Success and our clients to design and execute successful enrollments and engagement campaigns, both virtually and in-person. Travel onsite to clients to drive users' enrollment process in different locations across the United States. Assist with Marketing and Customer Success teams with feedback on how to improve enrollment events, actively providing solutions and problem-solving. Own member questions live and on-site, and escalating more complex issues to our Support and Developer teams as needed. Qualifications: Bachelor's degree or equivalent work experience Currently located on the East Coast, strong preference for the Northeast, near a major airport 2+ years experience working a customer-facing position, ideally working in a field role or events role managing logistics Professional work experience in a travel-heavy role with the ability to travel at least 50% of the time seasonally Comfortable working at different hours of the day. (ie, split shifts, early mornings, late nights to accommodate enrollment schedules) Ability to lift up to 30 pounds A valid Driver's License Nice to have: Bilingual in Spanish, both conversationally and in writing The US base salary range for this full-time position is $65,000.00 to $75,000.00. Salary ranges are determined by role and level. Compensation is determined by additional factors, including job-related skills, experience, and relevant education or training. Please note that the compensation details listed in US role postings reflect the annual salary and bonus only, and do not include equity or benefits. Hello Heart has a positive, diverse, and supportive culture - we look for people who are collaborative, creative, and courageous. Oh, and if you want to see some recent evidence of the fun things we do at Hello Heart, check out our Instagram page.
    $65k-75k yearly Auto-Apply 25d ago
  • Outreach & Enrollment Specialist

    Unity Care NW 3.6company rating

    Bellingham, WA jobs

    Compensation: Non-exempt, hourly The standard wage range for this role is $25.18 to $29.58 per hour It may be possible to earn more over time up to $34.02 per hour Work Schedule: Monday - Friday Full time, 40 hours, days Who We Are Unity Care NW is a private, non-profit, federally qualified health center (FQHC) that has been proudly and successfully serving the greater Whatcom County area since 1982. With clinics located in Bellingham & Ferndale, we offer comprehensive primary medical, behavioral health and dental care, as well as pharmacy services to a diverse and often underserved patient population of all ages. Employing more than 300 caring and compassionate employees, our mission is to increase the years of healthy life in the people & communities we serve. What We Value Respect Integrity Accountability Collaboration Innovation We strive to demonstrate our Values in Action in all that we do. We value each individual on our team and aim to onboard a workforce of the very best talent, whose ambitions and values align with ours. Job Summary As an Outreach & Enrollment Specialist, you would be responsible for connecting patients to high quality, affordable health care services by providing insurance enrollment, health care navigation support, and outreach to medically underserved populations. Primary responsibilities and duties include: Assists patients and community members with insurance enrollment. Assists with implementing outreach campaigns to connect patients to insurance and related resources. Documents and reports progress on all outreach and enrollment activities as required. Connects patients and community members to UCNW services and community resources. Processes Sliding Fee Discount Program applications. What We Offer A friendly & collaborative team environment A competitive compensation package Benefits Include: Medical, dental, & vision insurance 401(k) retirement plan with employer match after 1 year of eligibility 6 paid holidays Generous paid time off: 108 hours accrued in Year 1 gradually increasing to 196 hours per year over 10 years Paid sick leave Other paid leaves for Bereavement, Jury Duty & Bone Marrow/Organ Donation Life/AD&D insurance Variety of optional insurances including Supplementary Life/AD&D, Short Term and Long Term Disability, Critical Illness, Accident, and Travel as well as Identity Theft Protection Flexible Spending Account Self-funded Health Savings Account on Base Medical Insurance Plan Employee Assistance Program Alternative transportation incentives Healthy Living reimbursement Unique programs including Medical Hardship Payroll Loans, Employee Referral Bonuses & Will preparation services Requirements Professional and Technical Knowledge: Possesses a basic level of written and verbal communications skills, computational and computer skills and mathematical knowledge at a level typically acquired through completion of a general studies high school program. Possesses specific knowledge of Community Health (related field, or lived experience), processes and practices, typically learned on the job, or which may include a series of training sessions that would comprise a few weeks if done consecutively. Must possess additional expertise in the field of Community Health (related field, or lived experience), acquired through practice or exposure to various conditions, beyond the formal knowledge (or on the job training), allowing employees to perform more advanced techniques. Six (6) months related experience and/or training preferred. Bachelor's degree in a related field preferred. Experience working with underserved populations and cultural competency strongly preferred. Technical Skills: Knowledge of health insurance options including Medicare, Medicaid, private insurance, and managed care programs preferred. Ability to work in a demanding, fast-paced environment with constant public contact, frequent interruptions, and occasional crisis situations. Ability to understand and respond effectively and with sensitivity to special population groups, including those defined by race, ethnicity, language, age, gender, sexual orientation, economic standing, & others. Keyboarding speed of 55 wpm and data entry skills; accuracy is essential. Knowledge of and proficiency in Microsoft Office suite programs including but not limited to Word, Excel, PowerPoint, SharePoint, etc. Communications Skills: Possesses ability to effectively communicate information that is complex and/or technical to co-workers and others. Able to exercise tact and diplomacy in the resolution of mild conflicts or disagreements that occur on the job that would be considered at a level of basic “customer service”. Prepares effectively written communication (e.g., correspondence, memos, letters, emails) conveying information. Effectively communicates information during informal and formal verbal interactions. Ability to communicate bilingually in Spanish, a plus. To apply, visit our Careers Page at ******************** For news on our organization & future job postings, please follow us on LinkedIn at *********************** Unity Care NW has an Employee Health Program for the safety of our patients and staff. The program requires all new employees to have up to date vaccines for Covid-19 and influenza. More information about this program is provided throughout the recruitment process. If you feel this job posting is missing any required compensation or benefit information, please contact ***********. Other questions can be addressed throughout the recruitment process for candidates selected to move forward.
    $25.2-29.6 hourly Easy Apply 42d ago
  • ON-SITE Credentialing and Enrollment Specialist

    Mendocino Community Health Clinic 4.6company rating

    Ukiah, CA jobs

    Job DescriptionDescription: In this vital role, you will be responsible for ensuring accurate and timely credentialing of healthcare professionals and managing their enrollment processes with various insurance payors. Your expertise will help maintain compliance and support our commitment to providing access to high-quality patient care. Key Responsibilities: - Verify and maintain the credentials of healthcare professionals, including licenses, certifications, and educational qualifications - Manage the enrollment process of healthcare providers with multiple payor insurance plans - Ensure timely submission of credentialing and re-credentialing applications - Communicate effectively with Credentialing Verification Organization, healthcare providers, insurance companies, and internal teams to resolve issues - Monitor and track credentialing and enrollment statuses to ensure compliance with regulatory requirements Skills and Qualifications: - Strong organizational and administrative skills with attention to detail - Excellent communication and interpersonal skills - Ability to manage multiple tasks and meet deadlines in a fast-paced environment - Proficiency in Microsoft Office Suite - Proven experience in healthcare credentialing and insurance enrollment preferred - Knowledge of healthcare regulations and payor requirements preferred We offer a collaborative work environment, opportunities for professional growth, and a comprehensive benefits package. Requirements: Required: AA degree 1+ years' experience in a healthcare setting Preferred: Bachelor's degree in healthcare administration or related field 1+ years' experience in credentialing and enrollment
    $38k-47k yearly est. 23d ago
  • Credentialing Enrollment Specialist

    Advocate Health and Hospitals Corporation 4.6company rating

    Charlotte, NC jobs

    Department: 13213 Enterprise Corporate - Payor Relations Status: Full time Benefits Eligible: Yes Hours Per Week: 40 Schedule Details/Additional Information: has a first shift schedule between normal business hours of 8am to 5pm. Pay Range $23.65 - $35.50 Essential Functions 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. Physical Requirements Perform most duties under normal office conditions which may include sitting for long periods of time, standing, walking, using repetitive wrist/arm motion or lifting articles 20-50 pounds. Work is subject to time sensitivity, heavy volumes, and frequent interruptions, either by phone or other employees. Must use frequent and variable body movements during filing and maintaining records. Require frequent verbal and written communication in English to employees, corporate staff, providers, and external agencies. Require occasional travel to other corporate offices. Use of personal vehicle required. Intact sense of sight and hearing required. Education, Experience and Certifications 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 is required. Knowledge of and experience with personal computers, Windows and Microsoft applications, copier and fax machines and multi-line telephone required. Experience in typing, word processing, and business correspondence is required. Certification through National Association of Medical Staff Services (NAMSS) as Certified Provider Credential Specialist (CPCS) or Professional Medical Services Management (CPMSM) preferred. Our Commitment to You: Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including: Compensation Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training Premium pay such as shift, on call, and more based on a teammate's job Incentive pay for select positions Opportunity for annual increases based on performance Benefits and more 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 About Advocate Health Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation's largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.
    $23.7-35.5 hourly Auto-Apply 24d ago
  • Enrollment Specialist

    Health 4.7company rating

    Compton, CA jobs

    At Habitat Health, we envision a world where older adults experience an independent and joyful aging journey in the comfort of their homes, enabled by access to comprehensive health care. Habitat Health provides personalized, coordinated clinical and social care as well as health plan coverage through the Program of All-Inclusive Care for the Elderly (“PACE”) in collaboration with our leading healthcare partners, including Kaiser Permanente. Habitat Health offers a fully integrated experience that brings more good days and a sense of belonging to participants and their caregivers. We build engaged, fulfilled care teams to deliver personalized care in our centers and in the home. And we support our partners with scalable solutions to meet the health care needs and costs of aging populations. Habitat Health is growing, and we're looking for new team members who wish to join our mission of redefining aging in place. To learn more, visit ****************************** Role Scope: This is an opportunity for a highly motivated individual that's responsible for overseeing the enrollment process for prospective participants, ensuring a seamless experience from initial inquiry to enrollment. This individual will help to bring the PACE program to serve frail elders and disabled older adults in the Sacramento community. The Enrollment Specialist is a key player in introducing participants to and assessing them for our PACE program. As one of the first Habitat team touchpoints, this specialist will be the quarterback in partnership with the IDT (Interdisciplinary Team), Enrollment RN, and the Outreach Team to ensure a smooth enrollment process and continuity of care for prospective participants. This role requires a combination of excellent customer service skills, attention to detail, and proficiency in managing and processing enrollment-related documentation and data. Core Responsibilities & Expectations for the Role Act as the primary face of Habitat Health for and develop meaningful relationships with prospective participants, providing information, guidance, and support throughout the process. Contribute to a program experience that Participants want to join, a team culture that cares and creates joy, and an environment where all participants and team members belong. Continue to raise the bar. Constructively seek and share feedback and help us implement changes in order to improve clinical outcomes and experience for participants. Exhibit and honor Habitat's Values. Contribute to center growth objectives by establishing strong relationships with referrals, and by championing PACE and building awareness in the community Drive the enrollment process as the case manager for prospective participants, including reviewing, processing, and updating applications and required documentation, distributing relevant enrollment materials, and managing communications Conduct tele, home visits and in-center evaluations for the prospective participant for potential eligibility for care. Deliver high-quality customer service by addressing and resolving enrollment-related inquiries and concerns in a timely and professional manner. Work collaboratively with Outreach Team, Enrollment RN, IDT, and center leaders to create a joyful and smooth enrollment process for prospective participants. Monitor and report on enrollment metrics and trends to assist in strategic planning and decision-making. Prepare reports as needed for internal stakeholders. Stay informed about and ensure adherence to relevant policies, regulations, and procedures related to the enrollment process. Required Qualifications: Bachelor's degree or equivalent experience. Minimum of 1 years of experience in a customer service or sales role, preferably within a healthcare or relevant industry setting. Strong organizational skills with a keen eye for detail and accuracy and ability to manage multiple tasks and priorities in a dynamic environment Excellent verbal and written communication skills. Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint). Have 1 year of experience working with a frail or elderly population Be medically cleared for communicable diseases before engaging in direct participant contact, including a TB test. Have all immunizations up to date before engaging in direct participant contact. Proof of valid CA driver's license, personal transportation, good driving record and auto insurance as required by State law. Preferred Qualifications: Ability to adapt to changes and learn new systems quickly. Bilingual: Spanish strongly preferred. Experience with enrollment software or CRM systems. Experience working with the Medicare and Medicaid populations and within a healthcare organization. Degree in healthcare, business administration, or marketing. Compensation: We take into account an individual's qualifications, skillset, and experience in determining final salary. This role is eligible for medical/dental/vision insurance, short and long-term disability, life insurance, flexible spending accounts, 401(k) savings, paid time off, and company-paid holidays. The base salary begins at $68,640 annually; this role is also eligible for an uncapped monthly bonus-based on achievement of role and team goals. The actual offer will be at the company's sole discretion and determined by relevant business considerations, including the final candidate's qualifications, years of experience, skillset, and geographic location. Vaccination Policy, including COVID-19 At Habitat Health, we aim to provide safe and high-quality care to our participants. To achieve this, please note that we have vaccination policies to keep both our team members and participants safe. For covid and flu, we require either proof of vaccination or declination form and required masking while in participant locations as a safe as an essential requirement of this role. Requests for reasonable accommodations due to an applicant's disability or sincerely held religious beliefs will be considered and may be granted based upon review. We also require that team members adhere to all infection control, PPE standards and vaccination requirements related to specific roles and locations as a condition of employment Our Commitment to Diversity, Equity, and Inclusion: Habitat Health is an Equal Opportunity employer and committed to creating a diverse and inclusive workplace. Habitat Health applicants are considered solely based on their qualifications, without regard to race, color, religion, creed, sex, gender (including pregnancy, childbirth, breastfeeding or related medical conditions), gender identity, gender expression, sexual orientation, marital status, military or veteran status, age, national origin, ancestry, citizenship, physical or mental disability, medical condition, genetic information or characteristics (or those of a family member), or other status protected by applicable law. Habitat Health is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Habitat Health will take steps to provide people with disabilities and sincerely held religious beliefs with reasonable accommodations in accordance with applicable law. Accordingly, if you require a reasonable accommodation to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact us at *************************. E-Verify Participation Notice This employer participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. If E-Verify cannot confirm that you are authorized to work, this employer is required to give you written instructions and an opportunity to contact Department of Homeland Security (DHS) or Social Security Administration (SSA) so you can begin to resolve the issue before the employer can take any action against you, including terminating your employment. Employers can only use E-Verify once you have accepted a job offer and completed the Form I-9. Beware of Scams and Fraud Please ensure your application is being submitted through a Habitat Health sponsored site only. Our emails will come from @habitathealth.com email addresses. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission by selecting the ‘Rip-offs and Imposter Scams' option: *******************************
    $68.6k yearly Auto-Apply 60d+ ago
  • Outreach and Enrollment Specialist

    East Valley Community Health Center 3.7company rating

    Pomona, CA jobs

    Founded in 1970, East Valley Community Health Center is a Federally Qualified Health Center (FQHC) who's services include providing personalized, affordable, high-quality medical, dental, vision and behavioral health care through a community-based network within the East San Gabriel Valley and Pomona Communities. Our staff practices patient-centered care by serving each patient with a personalized care plan that meets their individual needs. Our patients have access to support services that include, nutrition, health education, case management, pharmacy, lab, and x-ray at our health center locations. East Valley serves the health care needs of uninsured and underserved individuals and families throughout our 8 health center locations. Our mission is to provide access to excellent health care while engaging and empowering our patients, employees, and partners to improve their well-being and the health of our communities. MAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: * Provide enrollment assistance (including but not limited to completing coverage applications, gathering required documentation, and troubleshooting the enrollment process) for uninsured individuals to access subsidized, low-cost and free health insurance programs through the health insurance market place and Medi-Cal. * Provide structured patient education on health coverage, engage in follow-up and offer renewal assistance for enrolled individuals. * Educate patients and community members on COVID-19 best practices including vaccine eligibility and booster requirements. * Establish trusting relationships with patients and their families while identifying and addressing patients' needs. * Provide ongoing navigation with patients and families to assure patient satisfaction, evidenced by patient retention. * Conduct outreach and in-reach strategies within the community with the goal of increasing the number of families enrolled with EVCHC. * Conduct in-reach activities at EVCHC sites to inform patients about health care coverage * Assists and/or completes additional tasks as assigned. POSITION REQUIREMENTS AND QUALIFICATIONS: * High School or GED required. Bachelor's Degree in health or social service-related field of study preferred or, a minimum of two years in the field equivalent combination of education and experience. * 2 or more years of experience working in community social service or healthcare environment. * Experience using technology such as a computer, web-based portal systems, and internet web browsers. * Experience tabling and performing community outreach. * Covered CA Enrollment Assister Certification strongly preferred. * Must have strong Microsoft Office 365 skills (ex: Outlook, Word, and Excel). * Must be able to type 45 words per minute. * Bilingual, Fluent in English/Spanish or English/Spanish/Mandarin required. DOE: $23.00 - $27.16 East Valley offers a competitive salary, excellent benefits to include medical, dental, vision, and defined contribution retirement plan. You will also enjoy work-life balance with paid time off and paid holidays throughout the year. Please apply to this position with your current resume. Principals only. Recruiters, please do not contact this job posting. EOE is the Law. It is the stated policy of EVCHC to conform to all the laws, statutes, and regulations concerning equal employment opportunities and affirmative action. We strongly encourage women, minorities, individuals with disabilities and veterans to apply to all of our job openings. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, or national origin, age, disability status, Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law. We prohibit Retaliation against individuals who bring forth any complaint, orally or in writing, to the employer or the government, or against any individuals who assist or participate in the investigation of any complaint or otherwise oppose discrimination.
    $36k-46k yearly est. 60d+ ago
  • Eligibility & Enrollment Specialist

    Indian Health Center of Santa Clara Valley, Inc. 4.3company rating

    San Jose, CA jobs

    : Eligibility & enrollment SpecialistReports To: Front Office Supervisor Status: Full-Time, Non-Exempt This position is responsible for helping clients enroll in health insurance programs; registering new and established patients in IHC services; conducting outreach to established clients at the Indian Health Center (IHC); assisting patients develop payment plans; and backing up the front desk. The IHC is a Patient Centered Health Home and all employees are an integral part of this model of care delivery. Duties & Responsibilities: Meet with new and established medical clients to inform them about the services offered at the IHC and to enroll them into health insurance programs or any available County coverage Greet patients in waiting room and help them to complete forms Conduct outreach calls to all of the IHC's American Indian clients and encourage them to come in and receive services Conduct outreach calls and mailings to new medical managed care enrollees Create an incentive system aimed at reducing the number of no show clients Provide back up to the receptionist and medical records when needed Develop payment plans if needed for clients Compile monthly statistics for the Medical Department's Board Report Will need to prepare the Eligibility report for registration Make new patient registration packets Confirm appointments Check voicemail daily, follow up with calls and make new patient appointments Maintain schedule for Medi-Cal eligibility worker Assist patients with Medi-Cal applications Assist eligible applicants with the Covered California enrollment process Will attend outreach events as needed Participate as a proactive representative of the Patient Centered Health Home Perform duties utilizing the Team-Based Approach Perform other duties as assigned Required Qualifications, Knowledge and Abilities: Associate degree in a medical related field or comparable A minimum of 2 years of experience in a medical setting in a similar position Able to read, write and speak English fluently Bi-lingual in Spanish preferred Knowledge of medical terminology, procedure codes, ICD-9 codes, and medical records handling Trained as Certified Enrollment Counselor for Covered California or willing to complete training within 3 months of being hired Vast knowledge of Federal and State health programs, and Qualified Health Plans of Cover California Working knowledge of computer programs such as Microsoft Window Experience with Electronic Health Records and patient registries Flexibility, initiative, reliability, and creativity Willingness to cross train for reception and medical records Excellent customer service Knowledge of and ability to relate to the American Indian community and other minority populations Possession of a valid California Driver License, automobile insurance, and a clean driving record. Will need to provide this at time of hire Ability to maintain strict confidentiality Ability to function independently and as a team member within diverse environments as well as with a diverse staff composition Demonstrated ability to perform multiple administrative functions simultaneously in an accurate, organized, and efficient manner. Ability to multitask and thrive in a fast-paced, constantly changing environment Ability to carry out all responsibilities in an honest, ethical and professional manner and demonstrate good judgment Physical Requirements: Ability to sit, stand and walk for extensive periods of time Manual and finger dexterity and eye-hand coordination sufficient to accomplish the duties associated with your job description Ability to lift up to 35 pounds Ability to stoop, squat, or bend frequently Corrected vision and hearing within normal range to observe and communicate with patients and professional staff Working Conditions: Exposure to all patient elements, including communicable disease and blood borne pathogens. Will be working in a fast paced medical environment which can be stressful and constantly changing conditions. Normal working hours are from 8:00 am until 5:00 pm with one hour for lunch. However, working hours may vary depending upon need. Will need to be flexible in performing tasks with limited discretion in making judgment decisions. Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than above, the Indian Health Center of Santa Clara Valley, Inc. is an equal opportunity employer including minorities, women, disabled and veterans. Approvals/Acknowledgements
    $36k-45k yearly est. Auto-Apply 60d+ ago
  • Eligibility & Enrollment Specialist

    Indianhealth Center of Santa Clara Valley 4.3company rating

    San Jose, CA jobs

    : Eligibility & enrollment SpecialistReports To: Front Office Supervisor Status: Full-Time, Non-Exempt This position is responsible for helping clients enroll in health insurance programs; registering new and established patients in IHC services; conducting outreach to established clients at the Indian Health Center (IHC); assisting patients develop payment plans; and backing up the front desk. The IHC is a Patient Centered Health Home and all employees are an integral part of this model of care delivery. Duties & Responsibilities: Meet with new and established medical clients to inform them about the services offered at the IHC and to enroll them into health insurance programs or any available County coverage Greet patients in waiting room and help them to complete forms Conduct outreach calls to all of the IHC's American Indian clients and encourage them to come in and receive services Conduct outreach calls and mailings to new medical managed care enrollees Create an incentive system aimed at reducing the number of no show clients Provide back up to the receptionist and medical records when needed Develop payment plans if needed for clients Compile monthly statistics for the Medical Department's Board Report Will need to prepare the Eligibility report for registration Make new patient registration packets Confirm appointments Check voicemail daily, follow up with calls and make new patient appointments Maintain schedule for Medi-Cal eligibility worker Assist patients with Medi-Cal applications Assist eligible applicants with the Covered California enrollment process Will attend outreach events as needed Participate as a proactive representative of the Patient Centered Health Home Perform duties utilizing the Team-Based Approach Perform other duties as assigned Required Qualifications, Knowledge and Abilities: Associate degree in a medical related field or comparable A minimum of 2 years of experience in a medical setting in a similar position Able to read, write and speak English fluently Bi-lingual in Spanish preferred Knowledge of medical terminology, procedure codes, ICD-9 codes, and medical records handling Trained as Certified Enrollment Counselor for Covered California or willing to complete training within 3 months of being hired Vast knowledge of Federal and State health programs, and Qualified Health Plans of Cover California Working knowledge of computer programs such as Microsoft Window Experience with Electronic Health Records and patient registries Flexibility, initiative, reliability, and creativity Willingness to cross train for reception and medical records Excellent customer service Knowledge of and ability to relate to the American Indian community and other minority populations Possession of a valid California Driver License, automobile insurance, and a clean driving record. Will need to provide this at time of hire Ability to maintain strict confidentiality Ability to function independently and as a team member within diverse environments as well as with a diverse staff composition Demonstrated ability to perform multiple administrative functions simultaneously in an accurate, organized, and efficient manner. Ability to multitask and thrive in a fast-paced, constantly changing environment Ability to carry out all responsibilities in an honest, ethical and professional manner and demonstrate good judgment Physical Requirements: Ability to sit, stand and walk for extensive periods of time Manual and finger dexterity and eye-hand coordination sufficient to accomplish the duties associated with your job description Ability to lift up to 35 pounds Ability to stoop, squat, or bend frequently Corrected vision and hearing within normal range to observe and communicate with patients and professional staff Working Conditions: Exposure to all patient elements, including communicable disease and blood borne pathogens. Will be working in a fast paced medical environment which can be stressful and constantly changing conditions. Normal working hours are from 8:00 am until 5:00 pm with one hour for lunch. However, working hours may vary depending upon need. Will need to be flexible in performing tasks with limited discretion in making judgment decisions. Preference is given to qualified American Indian/Alaskan Natives in accordance with the American Indian Preference Act (Title 25, U.S. Code Section 472, 473 and 473a). In other than above, the Indian Health Center of Santa Clara Valley, Inc. is an equal opportunity employer including minorities, women, disabled and veterans. Approvals/Acknowledgements
    $36k-45k yearly est. Auto-Apply 60d+ ago
  • Outreach and Enrollment Specialist

    Park Duvalle Community Health Centers 3.7company rating

    Louisville, KY jobs

    We are seeking a dedicated Outreach and Enrollment Specialist to join our team and play a vital role in connecting community members with essential health coverage options. This position offers an opportunity to make a meaningful impact by educating consumers about the Marketplace, Medicaid, and Children's Health Insurance Program (CHIP), empowering them to make informed decisions about their healthcare coverage. The ideal candidate will work collaboratively with community organizations and state systems to facilitate the enrollment process efficiently and effectively. Key Responsibilities: - Educate community members about health insurance options available through the Marketplace, Medicaid, and CHIP. - Motivate and guide consumers to select health coverage that best meets their individual needs. - Assist individuals in understanding eligibility requirements and the enrollment process. - Collaborate with partner organizations to coordinate outreach efforts and streamline enrollment activities. - Complete the enrollment process within state-approved systems, ensuring accuracy and compliance. - Maintain up-to-date knowledge of relevant policies, programs, and system changes. - Document outreach activities and enrollment data accurately for reporting purposes. - Provide excellent customer service and support to consumers throughout the enrollment process. Requirements Skills and Qualifications: - High school diploma or equivalent; additional education or experience in health education, social services, or related fields preferred. - Strong communication and interpersonal skills, with the ability to engage diverse populations. - Knowledge of health insurance programs, including the Marketplace, Medicaid, and CHIP. - Ability to explain complex information clearly and effectively. - Experience working with community organizations and in outreach or enrollment roles is a plus. - Proficiency with computers and familiarity with enrollment systems and data entry. - Ability to work independently and as part of a team, managing multiple priorities. - Valid driver's license and reliable transportation may be required for community outreach activities.
    $28k-33k yearly est. 60d+ ago
  • Enrollment Specialist

    Mosaic Community Health 4.0company rating

    Bend, OR jobs

    The Enrollment Specialist is the primary point of contact for Mosaic patients with insurance applications and eligibility requirements with state and/or federal insurance programs, including Oregon Health Plan. This includes contacting patients for re-enrollment and assisting the Billing Department with insurance verifications. The Enrollment Specialists will conduct Outreach activities with community partners and other organizations to provide information and enrollment assistance. This position will develop and maintain statistical enrollment reports and manage reports provided by the organization for enrollment and re-enrollment. This position will travel throughout the region to support enrollment assistance. Additionally, this role will be handling pre-registration and registration pre verification for all patients at Mosaic, new or established. Entering, auditing, educating, and advocating for accurate registration in the patient's electronic medical record (EHR). This role identifies patients who have termed from Medicaid/Medicare. When termed, reaches out to patients to inquire as to why they termed and assists patients in navigating the Enrollment process. Provides education on Medicaid eligibility and sliding scale eligibility. Bi-lingual in Spanish/English strongly preferred. Patient Enrollment * Aid and process state and/or federal applications for insurance coverage for patients and community members. * Troubleshoot application questions or concerns from patients and community members. * Serves as a liaison between state/federal systems and patient, providing timely follow-up and processing of applications and insurance eligibility status. * Timely documentation of all assistance including insurance eligibility status in the electronic medical record (EMR) per procedure. Outreach * Monitor enrollment reports to identify enrollment assistance needs. * Active patient outreach to capture patient eligibility status at patient visit. * Community outreach to educate and assist community members with enrollment needs. Customer and Access Services * Advise patients of their Enrollment status with Medicaid/Medicare and aid as needed * Advise patients of financial and/or insurance documentation required for appointments as well as educate patients on different payment options offered Scheduling * Schedule patients in Enrollment appointments as needed * Provide system or clinic support for New Patient and Enrollment scheduling, rescheduling, and cancellations * Confirm patient demographics, registration, and insurance information and update EHR as needed * Promote and educate, MyChart use Pre-Registration * Create new patient records in EHR * Patient activation and education on use and benefits of MyChart * Complete the patient registration process and document in the EHR * Educate patients on FPL, Medicaid, and Marketplace requirements as well as assisting with over the phone support when possible Registration Pre-Verification * Auditor of patient charts to ensure accurate financial registration * Updates patients charts to ensure accurate financial registration including coverage's, guarantors, demographics, annual incomes, and any other registration field that needs correcting * Reaches out to patients to get updated corrected information for accurate financial registration * Works with billing and site supervisors to coordinate needed paperwork and forms for patients * Working in basket messages relating to registration updates, Medicaid eligibility, and sliding scale eligibility Skills & Knowledge Working knowledge of health insurance plans including Medicaid and Medicare. Excellent oral and written communication skills, including effective communication with patients on complex or technical information regarding insurance coverage. Ability to develop and present effective presentations in different location settings and group size. Ability to prepare basic correspondence and simple reports in Microsoft Word and Excel. Ability to create, send and manage email in Outlook. Ability to access and use web-based applications and EMR program. Understanding of healthcare navigation including insurance types, concepts, terminology, billing, and/or regulations required. Knowledge of standard office policies and procedures. Knowledge of Microsoft Office software products preferred. Computer literacy and typing skills. Training in Marketplace enrollment preferred. Knowledge of standard office machines including copier, fax, shredder, multi-line telephone, printers, etc. Excellent customer service skills and ability to effectively and respectfully handle dissatisfied patients. Bi-lingual in Spanish/English strongly preferred. Who We Are Mosaic Community Health prides itself on being an innovative health system that pioneers unique and creative ways to provide and improve patient access to health care. Since our founding in 2002 we have proudly served insured and uninsured patients regardless of age, ethnicity, or income. We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way. At Mosaic Community Health, you will work with incredibly dedicated and mission-centered peers and be part of a dynamic team based environment. Mosaic Community Health offers more than just a job, it is a lifestyle. A lifestyle of serving others. A lifestyle of being an integral part of your community. A lifestyle that offers work/life balance. A lifestyle of enjoying the outdoors! Central Oregon offers over 300 days of sunshine a year, so enjoy a PTO day on the mountain, biking/hiking trails, or the river! A lifestyle that improves lives, including yours. Of course, we also offer a great benefit package!
    $31k-37k yearly est. 60d+ ago
  • Outreach and Enrollment Specialist

    East Valley Community Health Center 3.7company rating

    West Covina, CA jobs

    Founded in 1970, East Valley Community Health Center is a Federally Qualified Health Center (FQHC) who's services include providing personalized, affordable, high-quality medical, dental, vision and behavioral health care through a community-based network within the East San Gabriel Valley and Pomona Communities. Our staff practices patient-centered care by serving each patient with a personalized care plan that meets their individual needs. Our patients have access to support services that include, nutrition, health education, case management, pharmacy, lab, and x-ray at our health center locations. East Valley serves the health care needs of uninsured and underserved individuals and families throughout our 8 health center locations. Our mission is to provide access to excellent health care while engaging and empowering our patients, employees, and partners to improve their well-being and the health of our communities. MAJOR POSITION RESPONSIBILITIES AND FUNCTIONS: * Provide enrollment assistance (including but not limited to completing coverage applications, gathering required documentation, and troubleshooting the enrollment process) for uninsured individuals to access subsidized, low-cost and free health insurance programs through the health insurance market place and Medi-Cal. * Provide structured patient education on health coverage, engage in follow-up and offer renewal assistance for enrolled individuals. * Educate patients and community members on COVID-19 best practices including vaccine eligibility and booster requirements. * Establish trusting relationships with patients and their families while identifying and addressing patients' needs. * Provide ongoing navigation with patients and families to assure patient satisfaction, evidenced by patient retention. * Conduct outreach and in-reach strategies within the community with the goal of increasing the number of families enrolled with EVCHC. * Conduct in-reach activities at EVCHC sites to inform patients about health care coverage * Assists and/or completes additional tasks as assigned. POSITION REQUIREMENTS AND QUALIFICATIONS: * High School or GED required. Bachelor's Degree in health or social service-related field of study preferred or, a minimum of two years in the field equivalent combination of education and experience. * 2 or more years of experience working in community social service or healthcare environment. * Experience using technology such as a computer, web-based portal systems, and internet web browsers. * Experience tabling and performing community outreach. * Covered CA Enrollment Assister Certification strongly preferred. * Must have strong Microsoft Office 365 skills (ex: Outlook, Word, and Excel). * Must be able to type 45 words per minute. * Bilingual, Fluent in English/Spanish or English/Spanish/Mandarin required. DOE: $23.00 - $27.16 East Valley offers a competitive salary, excellent benefits to include medical, dental, vision, and defined contribution retirement plan. You will also enjoy work-life balance with paid time off and paid holidays throughout the year. Please apply to this position with your current resume. Principals only. Recruiters, please do not contact this job posting. EOE is the Law. It is the stated policy of EVCHC to conform to all the laws, statutes, and regulations concerning equal employment opportunities and affirmative action. We strongly encourage women, minorities, individuals with disabilities and veterans to apply to all of our job openings. We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, gender, sexual orientation, gender identity, or national origin, age, disability status, Genetic Information & Testing, Family & Medical Leave, protected veteran status, or any other characteristic protected by law. We prohibit Retaliation against individuals who bring forth any complaint, orally or in writing, to the employer or the government, or against any individuals who assist or participate in the investigation of any complaint or otherwise oppose discrimination.
    $36k-46k yearly est. 60d+ ago
  • Enrollment Specialist

    Institute of Healthcare Professions, LLC 3.6company rating

    Boynton Beach, FL jobs

    Description: International College of Health Sciences (ICHS) is seeking an enthusiastic and detail-oriented Enrollment Specialist to support the admissions efforts of the organization. This role is vital in systematically and ethically recruiting qualified applicants for admissions to the College, in accordance with college, state, federal, and accreditation regulations. The ideal candidate will possess strong communication and organizational skills and will uphold the mission, vision, and core values of ICHS. Located in the vibrant Boynton Beach area of Florida, ICHS is dedicated to shaping the future of healthcare professionals through innovative educational approaches. Onsite: Boynton Beach, FL Schedule: Tuesday to Saturday, 11:00 am to 8:00 pm eastern Purpose The Enrollment Specialist will be responsible for driving the admissions process by managing inquiries, providing clear and accurate information to prospective students, and ensuring all required documentation and compliance standards are met. This position supports prospective students throughout their application process, guides them through the completion of enrollment requirements, and promotes the College's programs and offerings. Responsibilities Admissions Management and Communication Independently manage inquiries to achieve prompt contact and performance activity using approved recruitment policies. Make prompt and effective contact with inquiries, redirect unqualified candidates, and document all interactions in the College Student Management System. Maintain a high quantity of outgoing phone calls and scheduled interviews to meet activity requirements. Secure new inquiries through Personally Developed Referrals. Address applicant concerns and support their transition into the College. Guide prospective students through the completion of the enrollment process and assist applicants in completing program applications. Compliance and Information Accuracy Uphold the highest standard of ethics and truthfulness in communications regarding educational programs, facilities, costs, financing, licensure, completion, graduation, and placement data. Provide clear and accurate information per college, federal, state, and accreditation guidelines. Ensure compliance with applicable regulations; communication may be monitored/recorded as needed. Collaborate effectively across college departments for efficient student enrollment. Outreach and Events Represent the College at high school, community outreach, and other events, schedule and present on behalf of the College. Provide tours to prospective students prior to enrollment. Student Records and Compliance Ensure all required enrollment documents are complete and organized before the student attends class. Document all recruitment and enrollment activities in the student management system as required by policy. Additional Responsibilities Complete other duties or tasks as assigned. Demonstrate a cooperative, professional, and student-focused approach. Follow all department and college operating procedures. Requirements: Qualifications Education / Experience / Knowledge Associate's degree or higher preferred; High school diploma or equivalent required. One (1) to three (3) years of relevant experience or equivalent combination of education and experience. Required Experience and Skills Sincere interest in helping others achieve life goals. Excellent written and verbal communication skills. Strong interpersonal, organizational, and problem resolution skills. Goal-oriented and highly ethical. Proficiency in MS Office and basic computer skills. Ability to interact effectively as a leader and member of a team. Flexibility and adaptability to changing assignments and priorities. Ability to manage multiple tasks and meet deadlines successfully. Desired Experience in student recruitment, admissions, or higher education preferred. Additional Information:At no time may work be performed, or computer systems accessed, from outside of the U.S. Individuals hired must be able to perform essential duties satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Please note that the responsibilities outlined in this job description are not exhaustive and may be supplemented as necessary. International College of Health Sciences provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, pregnancy or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
    $27k-44k yearly est. 11d ago
  • Enrollment Specialist

    Connections for Children 4.1company rating

    Los Angeles, CA jobs

    Description: Connections for Children (CFC) is a non-profit Child Care Resource and Referral agency serving child care providers, educators, and parents in the West Los Angeles and South Bay communities. For nearly 50 years, CFC has been a key community resource, empowering families and child care providers to ensure every child has access to quality early care and education. Through child care referrals, financial assistance, family engagement, and workforce development programs, CFC strengthens the link between families, providers, and the broader community, promoting the well-being and optimal development of young children. Committed to equity and excellence, CFC is a steadfast advocate for the nurturing and educational needs of all children, continually evolving to meet the changing demands of the community. Connections for Children is focused on expanding programs to serve more people throughout our service area, while investing in staff and organizational capacity to ensure mission success. By establishing a more diverse revenue base, CFC is sustaining and growing its impact, prioritizing equity, and inclusivity in all efforts. This prioritization affirms CFC's commitment to diversity, equity, inclusion, and belonging, particularly in serving underserved populations, and positions the organization to embrace innovation and cultivate strong partnerships for the betterment of countless children and families. About the Position In accordance with the organizational mission and goals, provides direct or program related services to the clients within assigned programs while ensuring compliance with all city, county and state subsidy child care contracts. Primary Responsibilities Participate in the recruitment and enrollment of new clients in the subsidy program by: Conduct in-person meetings, both scheduled and by walk-in, with clients in order to receive and process documentation needed for enrollment Provide information and support to clients on child care options. Work with outside agencies to verify clients' needs and eligibility for service. Manage, review and verify all eligibility required documentation for enrollment of clients within a timely manner and according to programs required time frame. Evaluate all client income in the household and apply a family fee if applicable. Maintain, complete, and organized client files according to program regulations and guidelines to satisfy program audits. Manage assigned caseload, ranging from 100-200 clients. Maintain knowledge of the Title 5 Regulations and State Funding Terms and Conditions for all applicable programs. Keep up-to-date on timely subsidy program changes and related guidance. Maintain current and accurate client records in MCT-CC3 and CalSAWs databases. Maintain confidentially of clients Personal Information as required by contracts. Ensure clients complaints are accurately logged and resolved in a timely manner or referred to Subsidized Programs Supervisor for appropriate resolution. Additional Responsibilities Provide clients with information on supportive services (e.g., housing, food, mental health services, etc.) as needed. Represent the agency with professionalism in all interactions. This includes over the phone, in person, using electronic media, and written correspondence. Provide excellent internal and external customer service by working cooperatively within the department, across the agency, and with clients and partners. Support other functions within the department when needed. Participate in visibility events as needed. Attend all staff meetings, trainings, and annual retreats. Perform other duties as assigned Requirements: Experience, Knowledge, Skills and Abilities Regular attendance and punctuality are essential. Experience working with diverse populations in a culturally sensitive manner. Must be able to work independently and as part of a team. Excellent interpersonal skills, flexible and collaborative. Well-organized, able to self-manage competing priorities, and meet deadlines. Exceptional attention to detail and accuracy. Ability to exercise discretion and practice good judgment at all times. Computer Skills: Working knowledge of Microsoft Office (Word, Excel, Outlook, Teams) required. Bilingual English/Spanish Skills: Excellent Reading, Writing, and Oral Communication is preferred. Three (3) years of equivalent related work experience in Social Work, Human Services, Family Studies, or related field; or Bachelor's degree in the field of Social Work, Human Services, Family Studies, or related field. Working Conditions Typical of an office environment. Eligible for hybrid/telework schedule upon completion of introductory period. Must have reliable transportation. Flexibility to work occasional evenings and weekends. Must comply with agency health and safety protocols, including vaccination policy. Benefits include: Medical, dental, and vision coverage (employee premium fully paid), employer-paid life insurance, 401(k) with potential employer contribution, PTO and paid holidays. ORGANIZATIONAL STATEMENT This is intended to provide an overview of the requirements of the position. As such, it is not necessarily all-inclusive, and the job may require other essential and/or non-essential functions, duties, or responsibilities not listed herein. Management reserves the sole right to modify this at any time. Nothing in this job description is intended to create a contract of employment of any type. Employment at Connections for Children is strictly on an at-will basis. EQUAL OPPORTUNITY EMPLOYMENT STATEMENT Connections for Children is committed to the principle of equal employment opportunity for all employees and providing employees with a work environment free of discrimination and harassment. All employment decisions at Connections for Children are based on organizational needs, job requirements and individual qualifications, without regard to age, race, color, religion or belief, sex, sexual orientation, gender identity, national origin, veteran, disability status, family or parental status, or any other status protected by federal and CA state laws.
    $39k-44k yearly est. 20d ago

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