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Enrollment Coordinator

Company: Elderwood Health Plan
Location: Tonawanda
Posted on: September 12, 2021

Job Description:

Join Our Team: Join our strong and growing company today! Overview:

Elderwood Health Plan, a managed medicaid provider plan, is currently seeking an Enrollment Coordinator to join our team!

 

The primary purpose of the Enrollment Coordinator is to provide assistance to potential members and facilitate plan membership. The Enrollment Coordinator will also monitor applications submitted to the Local Departments of Social Services (LDSS) and Maximus, track progress and report on any challenges. The Enrollment Coordinator will screen new candidates and identify eligible potentials related to both long-term care needs and Medicaid coverage for enrollment. This includes but is not limited to providing potential members and their families with education regarding the MLTC model of care.

Responsibilities:
  • Answer product and/or service questions.
  • Complete all necessary paperwork, documentation, and follow-up as required (i.e. enrollment application, lead reports, outreach logs, scheduling and other administrative work).
  • Establish contact, assess individual's needs and concerns, establish eligibility, provide overview of organizational mission, effectively and clearly present benefits of products in accordance with all Governmental regulations.
  • Conduct individual client screening to assess for Medicaid funded Long Term Care eligibility, follow-up with State Brokers to ensure proper handling of the Medicaid MLTC application process, and facilitate Conflict Free Enrollment Center appointments for evaluations for MLTC enrollment.
  • Assist with the screening of candidates toward identification of qualified, eligible potentials related to both long-term care needs and Medicaid coverage for enrollment
  • Provide potential members and their families with education regarding the MLTC model of care.
  • Help process calls from interested parties for potential enrollees.
  • Complete pre-enrollment screening form for all potential enrollees.
  • Work with EMR and State Electronic Systems for new enrollment management
  • Assist Social Work Care Manager with enrollment responsibilities
  • Educate potential enrollees on the plan benefits and provider network.
  • Tracks all enrollment and disenrollment information and communicates with EHP billing department.
  • Ensures that all enrollment and disenrollment activities are documented accurately in the member electronic health record.
  • Communicates with RN Care Managers and outside vendors regarding scheduling of initial UAS assessment.
  • Submission of all potential enrollments/disenrollments to the New York State broker MAXIMUS.
  • Other assigned duties as necessary
Qualifications:
  • Associates degree required, Bachelors preferred
  • Valid NYS Driver’s Licence
  • Bilingual fluency in Spanish, preferred
  • Must be in good standing with the Medicare and Medicaid programs
  • Proficiency in Microsoft Office: Excel, Word, Access; Internet navigation, required
  • Excellent Communication
  • Ability to solve diverse problems that require interpretation of administrative and/or technical issues.
  • HIPAA Privacy compliance.

 

Elderwood expects all current and new employees to be vaccinated against COVID-19. If hired, you will be required to provide proof of vaccination. Employees may request a medical exemption from vaccination.

 

*MSTR

Employee Perks!: 401K Retirement Plan with Company Match, Close to thruway entrances/exits, Conveniently located on a bus route, Free On-Site Parking, Friendly and supportive staff, Generous PTO & holiday package, Life Insurance, Medical, Dental, and Vision insurance, Relaxing employee lounge with free iced/hot coffee, Strong leadership, Substantial employee referral program EOE Statement: WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

Keywords: Elderwood Health Plan, Tonawanda , Enrollment Coordinator, Other , Tonawanda, New York

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