Eligibility specialist vs enrollment specialist

Differences between eligibility specialist and enrollment specialist duties and responsibilities

Eligibility specialist example responsibilities.

• Manage assignments of paying medical bills limit in depth that include organizing and researching regulations as pertain to veterans eligibility.
• Demonstrate competency in basic understanding of Medicaid, policies, forms and DHS policy.
• Coordinate these efforts by working with DES staff, other state agencies, FEMA and other volunteering private organizations.
• Conduct Medicaid and TANF eligibility interviews.
• Interview patients using multiple data base system to assess and determine Medicaid eligibility coverage for long term care services.
• Experience with disability claim process as DHS eligibility worker desire.
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Enrollment specialist example responsibilities.

• Manage the TRICARE information program by presenting information utilizing available media, group presentations, or mailings.
• Manage customer relations with internal personnel, group administrators, brokers and members as related to HMO commercial insurance.
• Maintain records pertaining to eligibility and enrollment by managing CMS reports.
• Provide enrollment counseling to eligible recipients about Medicaid manage care and promote their voluntary enrollment into an HMO.
• Analyze, process and manage FMLA claims to determine eligibility and certification in compliance with state and federal regulations.
• Assist medical assistance consumers with choosing HMO's and PCP as well as with HMO and PCP transfers.
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