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Become An Enrollment Specialist

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Working As An Enrollment Specialist

  • Getting Information
  • Analyzing Data or Information
  • Communicating with Supervisors, Peers, or Subordinates
  • Interacting With Computers
  • Evaluating Information to Determine Compliance with Standards
  • Mostly Sitting

  • $73,310

    Average Salary

What Does An Enrollment Specialist Do At Healthcare Support

* This Enrollment Specialist will be responsible for the processing of enrollment and disenrollment of company s members; maintenance of the company s eligibility information; and systematic transmission of authorization and referral files to and from the appropriate company vendors.
* Receives and processes member enrollment and disenrollment cards.
* Downloads and processes eligibility files from the State of Wisconsin in a timely manner to assure timeliness of referral/authorization and claims processing.
* Maintains eligibility tables/data files and assure accuracy in enrollment reports as identified in enrollment processes.
* Provide administrative support to Claims/Enrollment/Member Services Manager as necessary

What Does An Enrollment Specialist Do At Kaiser Permanente

* Engage local/branch account contacts to ensure understanding of and commitment to KP.
* Engage union contacts to ensure understanding of and commitment to KP.
* Develop and execute strategies for open enrollment.
* Initiate opportunities outside of open enrollment to engage with members and potential members to ensure understanding of and commitment to KP.
* Identify and work new hire enrollment strategies in targeted accounts.
* Analyze open enrollment opportunities and propose options to maximize KP's visibility.
* Communicate purchaser issues regarding accounts and book of business to account manager accurately and within specified time frame.
* Identify and report purchaser trends to internal stakeholders.
* Manage materials fulfillment needs of assigned groups on an ongoing basis

What Does An Enrollment Specialist Do At Randstad

* Review and screen provider enrollment applications for Nebraska Medicaid.
* Research, verify and document information pertaining to providers using secure external web services
* Provides excellent customer service by managing provider calls, obtaining information and answering questions, and in specific instances, refers callers to the Operations Manager for service and/or resolution.
* Communicates with providers about ongoing enrollment status in accordance with set policies and procedures.
* Working hours: M
* F, 8am
* pm

What Does An Enrollment Specialist Do At Hawaii Medical Service Association

* Processes a variety of membership changes, which may include complex transactions that require special handling.
* Investigates transactions that did not go through the processing system by completing research and correction of errors within expected standards of performance for quality and production.
* Outreach and respond to telephone and email inquiries from members, third party administrators, and groups in a professional and timely manner to resolve the inquiry or problem.
* This includes documentation of the inquiry and its resolution and represents the second tier of customer support.
* Assists with group configuration updates, when necessary.
* Performs validation and audits to ensure that all conversions and daily synchronization of data to Benefitfocus are complete and accurate.
* Researches any rejects for group and member loads.
* Performs other duties as assigned

What Does An Enrollment Specialist Do At Tad PGS, Inc.

* Reviews and screens provider enrollment applications for Nebraska Medicaid.
* Researches, verifies and documents information pertaining to providers using secure external web services and t to complete screening and enrollment tasks as defined in the Project’s policies, procedures, and protocols as applicable for this position.
* Provides excellent customer service by managing provider calls, obtaining information and answering questions, and in specific instances, refers callers to the Operations Manager for service and/or resolution.
* Communicates with providers about ongoing enrollment status in accordance with set policies and procedures.
* Notifies providers regarding incorrect or missing information and documentation in the Decision Point provider screening and enrollment system
* Works with Site Visit Field Staff to verify results from site visits.
* Works closely with the Customer Service Representatives and Mail Specialist and will also be cross-trained in these areas.
* Maintains updated knowledge of the Provider Enrollment and Screening Project including policies and procedures as referenced in the employee manual and other policies adopted by corporate, the Project and Client, and as referenced in Desk Procedures for the Department and this position.
* Adheres to the Standard Operating Procedures for this position.
* Meets and/or exceeds Production and Quality Assurance goals as defined for this position.
* Adheres to the Standard Operating Procedures for this position.
* Meets Production and Quality Assurance goals as defined in policy for this position.
* Immediately escalates any issues and/or concerns to the Operations Manager to ensure compliance to contractual requirements.
* Cross-trained to provide back-up support to the Customer Service Specialists or Mail Specialist.
* Other duties as may be assigned by management

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How To Become An Enrollment Specialist

Compensation, benefits, and job analysis specialists typically need a bachelor’s degree, and some specialists need related work experience.

Education

Most employers require that compensation, benefits, and job analysis specialists have a bachelor’s degree. Many specialists have a degree in human resources, business administration, finance, communication, or a related field. Some employers may accept previous work experience in lieu of a formal degree.

Not all colleges and universities offer an undergraduate degree in human resources, but many offer courses in human resources management, compensation analysis, and benefits administration. Students with a background in other disciplines may benefit from taking courses in business, management, finance, and accounting.

Work Experience in a Related Occupation

For many jobs, compensation, benefits, and job analysis specialists must have previous work experience. Employers commonly require that the previous experience includes performing compensation analysis, benefits administration, or general human resources work. Experience in related fields such as finance, insurance, or business administration, also may be beneficial.

Jobseekers without a degree in human resources must have relevant work experience. Some workers may gain this experience through internships. However, most gain experience from working in human resources.

Licenses, Certifications, and Registrations

Although certification is not required, it can demonstrate professional expertise. Some employers prefer to hire certified candidates, but many employers will have their employees become certified after they are already working. Certification programs for management positions often require several years of related work experience in order to qualify for the credential.

Many associations for human resources workers offer classes to enhance the skills of their members. Some associations, including the International Foundation of Employee Benefit Plans and WorldatWork, offer certification programs that specialize in compensation and benefits. Others, including the HR Certification Institute and the Society for Human Resource Management, offer general human resources credentials.

Advancement

Compensation, benefits, and job analysis specialists may advance to a compensation and benefits manager or a human resources manager position. Specialists typically need several years of work experience to advance.

Important Qualities

Analytical skills. Many specialists perform data or cost analyses to form logical conclusions. For example, they may analyze the cost of choosing a particular salary scale for a class of workers.

Business acumen. Specialists must understand basic finance and accounting.

Communication skills. Specialists often work with employees throughout their organization to provide information on compensation and benefits. They may give presentations or advise managers or employees about compensation policies or benefit plans.

Critical-thinking skills. Specialists must think critically when evaluating job positions, salary scales, promotion practices, and other compensation and benefits policies.

Detail oriented. Specialists must pay attention to detail, especially when ensuring that the organization is compliant with federal and state laws.

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Enrollment Specialist jobs

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Enrollment Specialist Career Paths

Enrollment Specialist
Eligibility Specialist Social Worker Admissions Coordinator
Assistant Director Of Admissions
5 Yearsyrs
Human Resources Coordinator Program Manager Senior Manager
Associate Director
8 Yearsyrs
Credentialing Specialist Data Analyst Assistant Vice President
Associate Vice President
10 Yearsyrs
Claim Specialist Human Resources Coordinator Benefits Manager
Benefit Director
11 Yearsyrs
Support Specialist Analyst Human Resources Coordinator
Benefits Manager
8 Yearsyrs
Customer Care Specialist Billing Specialist
Business Office Manager
8 Yearsyrs
Eligibility Specialist Home Health Aid Call Center Representative
Call Center Manager
6 Yearsyrs
Specialist Case Manager
Career Manager
6 Yearsyrs
Credentialing Specialist Provider Relations Representative Contracts Manager
Compliance Manager
9 Yearsyrs
Analyst Human Resources Coordinator Human Resources Manager
Corporate Human Resources Manager
8 Yearsyrs
Claim Specialist Accounts Receivable Specialist Benefit Specialist
Employee Benefits Manager
7 Yearsyrs
Business Analyst Assistant Vice President Human Resources Coordinator
Human Resources Contractor
9 Yearsyrs
Customer Care Specialist Account Manager Human Resources Coordinator
Human Resources Generalist/Manager
6 Yearsyrs
Specialist Account Manager Operations Manager
Human Resources Manager
7 Yearsyrs
Analyst Assistant Vice President Office Manager
Practice Manager
9 Yearsyrs
Project Coordinator Operations Manager Realtor
Property Management Specialist
6 Yearsyrs
Business Analyst Business Manager Human Resources Manager
Resource Project Manager
8 Yearsyrs
Support Specialist Program Coordinator Human Resources Coordinator
Senior Human Resources Administrator
6 Yearsyrs
Human Resources Coordinator Human Resources Generalist
Senior Human Resources Generalist
7 Yearsyrs
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Enrollment Specialist Demographics

Gender

  • Female

    74.8%
  • Male

    22.5%
  • Unknown

    2.7%

Ethnicity

  • White

    77.8%
  • Hispanic or Latino

    13.2%
  • Asian

    6.8%
  • Unknown

    1.5%
  • Black or African American

    0.7%
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Languages Spoken

  • Spanish

    76.7%
  • French

    6.0%
  • Hindi

    1.7%
  • Korean

    1.7%
  • Carrier

    1.7%
  • Mandarin

    1.3%
  • Portuguese

    1.3%
  • German

    1.3%
  • Gujarati

    0.9%
  • Vietnamese

    0.9%
  • Russian

    0.9%
  • Italian

    0.9%
  • Japanese

    0.9%
  • Cantonese

    0.9%
  • Arabic

    0.9%
  • Swedish

    0.4%
  • Turkish

    0.4%
  • Romanian

    0.4%
  • Samoan

    0.4%
  • Somali

    0.4%
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Enrollment Specialist

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Enrollment Specialist Education

Enrollment Specialist

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Real Enrollment Specialist Salaries

Job Title Company Location Start Date Salary
Enrollment Specialist Metropolitan College of New York New York, NY Jan 07, 2016 $47,500
Enrollment Specialist Utah Health Policy Project Salt Lake City, UT Jul 26, 2013 $38,000
Graduate Enrollment Specialist (Analyst) Andrews University Berrien Springs, MI Jan 06, 2013 $35,589
Recruiter/Enrollment Specialist Troy University Arlington, VA May 09, 2010 $34,000

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Top Skills for An Enrollment Specialist

MedicareAdvantageCustomerServiceMemberEligibilityProceduresDataEntryEnrollmentProcessEnrollmentAssistanceHealthInsuranceFinancialAidHealthCoverageOutreachOutboundCallsOnlineHealthPlanCMSInboundCallsEnrollmentApplicationsOpenEnrollmentNewMembersPhoneCalls

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Top Enrollment Specialist Skills

  1. Medicare Advantage
  2. Customer Service
  3. Member Eligibility
You can check out examples of real life uses of top skills on resumes here:
  • Enrolled participants into their appropriate Medicare Advantage Plans.
  • Interact with internal and external customers to provide claims information, customer service, and/or membership support.
  • Determined member eligibility prior to enrollment into plan.
  • Educate benefit administrators on processes and procedures for new hires, changes and terminations of employees.
  • Performed data entry/order entry duties in cooperation with corporate guidelines.

Top Enrollment Specialist Employers

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