The Enrollment Member Service Representative is responsible for processing initial referrals and reviewing patient information referred to Nascentia Options, LLC. Coordination and collaboration with Enrollment R.N. Specialists and external agencies.
Provides general program information to callers who can be prospective enrollees, families, caregivers, community liaisons, and professionals within the community.
Collects demographic information and complete Intake Inquiry form.
Creates referral profile in electronic medical record/database.
Creates electronic member chart with enrollment documents. Scan all appropriate enrollment material to the chart/database
Obtain necessary information from primary care physicians.
Responsible for processing all required enrollment files and information to Maximus.
Communicate required information to appropriate county department of social services.
Create welcome letters, member ID cards and coordinate mailing to members.
Responsible for tracking necessary member information to be sent to various agencies and departments.
Demonstrate effective interpersonal skills while demonstrating critical thinking and common sense resolution.
Meet routine deadlines and work schedules as well as timely and accurate completion of work.
All other duties as assigned
High School Diploma or equivalent required. College degree preferred.
Minimum of one year customer service experience required, preferably in a health care setting.
Previous experience in Enrollment, Claims Management, or Member Services preferred.
Excellent oral, verbal, and written communication skills
Exceptional customer service skills required.
Ability to organize and prioritize daily.
Accuracy and attention to details and follow through.
Ability to handle large volume of calls. Must be congenial on the phone.
PC skills including Microsoft Office and database management required.
Bilingual skills preferred.
Compensation & Benefits:
Competitive Salary with:
401K with generous Employer match
No rotating shifts
Medical, Dental, Vision plans
Partially funded HSA
Short/Long term Disability
Employee Assistance Program ( EAP)
Nascentia Health is an Equal Opportunity Employer ( EOE)
Employment is contingent upon negative results of a pre-hire drug screen