Enrollment Specialist

Pierce Technology Corp Dayton , OH 45401

Posted 1 week ago

  • Process work items according to appropriate regulatory guidelines
  • Review files and interpret the data to enter members into eligibility systems
  • Completion of daily change file pre-processor exceptions and monthly full file pre-processor exceptions
  • Research member eligibility and take appropriate actions to resolve issues across all eligibility systems
  • Process mass Primary Care Physician (PCP) changes with Provider Operations
  • Research, review, and interpret eligibility data to respond to eligibility inquiries from contracted vendors
  • Access state and federal government systems to review and confirm eligibility status
  • Process paper applications received for all applicable lines of business
  • Inbound phone coverage to answer inquiries from both internal and external customers
  • Complete all required corporate training within stated timelines to a satisfactory manner
  • Perform any other job related instructions, as requested

Requirements

  • Familiarity with Microsoft Word and Excel
  • Excellent verbal and written communication skills
  • Ability to work independently and within a team environment
  • Attention to detail
  • Familiarity of the healthcare field
  • Knowledge of Medicaid and Medicare preferred
  • Critical listening and thinking skills
  • Proper grammar usage
  • Time management skills
  • Proper phone etiquette
  • Customer service oriented
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Enrollment Specialist

Pierce Technology Corp