Enrollment Specialist

Call Center & Customer Service
in Lake Mary
, FL
Reference: 19-03172


The Enrollment Specialist is responsible for reviewing applications and enrollment records for all lines of business to ensure members are enrolled and data is entered with complete accuracy into the system and into the correct benefit package.

Duties & Responsibilities: 

  • Process enrollment applications received on a daily basis
  • Complete eligibility screens and routes appropriately for timely submission to local Departments of Social Services
  • Ensure Quality Assurance and Integrity forms are complete and accurate prior to transmitting the application for data entry
  • Verify prospective member eligibility and enrollment history through systems to include ePaces and Member Health Services (MHS)
  • Ensure applications are labeled correctly and routed out of data management system timely and accurately
  • Review, complete and monitor reports including the data entry of 834 enrollment records
  • Work as a team to accomplish larger application goals and independently with little supervision when completing assigned tasks or other responsibilities
  • Serves as liaison between Enrollment and various departments
  • Additional duties and special projects as assigned

 Minimum Qualifications: 

  • High School diploma or GED equivalent from an accredited institution
  • Work experience of multitasking between programs, data entry or client look up systems
  • Experience working with multiple Microsoft Excel worksheets including filtering and updating information on a daily basis
  • Experience using Microsoft Outlook including email, tasks and calendar functions
  • Experience using Microsoft Word for creating letters, memos and general correspondence
  • Ability to work overtime as the business requires

Preferred Qualifications: 

  • Detail-oriented
  • Bachelor’s degree from accredited institution
  • Ability to solve problems and find solutions
  • Effective verbal and written communication skills
  • Previous auditing or analytical experience
  • 1-3 years of work experience reviewing, approving and processing applications or member records
  • Experience with reviewing New York state Medicaid/Medicare Health plans