Enrollment Specialist/Eligibility Counselor I

Full time
20$/h
pembroke-pines 01/08/2017   Full time 20$/h

On March 1, 2017 McKesson Corporation (NYSE MCK) and Change Healthcare Holdings, Inc., formed a new healthcare information technology company, setting an incredibly exciting course for the future. The entity combined substantially all of Change Healthcare’s 
business and the majority of McKesson Technology Solutions (MTS) into the new company. 

CULTIVATING A CAREER WITHIN CHANGE HEALTHCARE 

Our culture is guided by our core values which are woven into the fabric of every aspect of our company; Pursue Purpose, Champion Innovation, Earn Trust, Be Agile, and Include All. 

Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system! 

POSITION SUMMARY:
This position services to assist low-income Medicare be beneficiaries enrolled in a contracted Managed Care Organization Medicare+Choice health plan, with the qualification and recertification process for Medicare Savings Programs. The recertification team 
conducts telephonic outreach to remind, assist, and keep the members enrolled by either phone outreach or mailings. This outreach is performed before and around the members’ recertification date. 

RESPONSIBILITIES:

  • Conducts telephonic outreach activities for members who need to recertify and are eligible for the Medicare Savings Programs. May also need to contact the state to properly complete the recertification process and to verify case status.
  • Completes MSP renewal applications if needed, for members. This would occur in the case that the member is unable to do so, and sends it to My Advocate for completion. Also, insure that applications are completely filled out and every questions is answered

correctly before sending it back to member for signature. 

  • Offer Community Link services to find additional programs that may assist members with their needs and interests. Must also conduct follow-up for incomplete application/documents for certain programs.
  • Conduct telephonic outreach to AL and MI members when their renewal application is received by the Government Relations department. Inform members the application will be sent to their physical address via mail (overnight). Must also provide instructions

on how to complete the process. 

  • Contact members when “Will-Stop” Notices have been received in order to avoid interruption of member’s benefits. Instruct member to contact state to complete renewal process before the end date.
  • Must conduct proper and effective follow-up to ensure state renewal applications are sent to the state in a timely manner and Altegra Health documents are received to conduct further assistance.
  • Meet daily, weekly, and monthly production goals. Must also meet quality standards by ensuring proper phone etiquette and adherence to scripts, make accurate and descriptive MMS documentation.
  • Participates as required in Altegra Health's staff and operational development programs. Acts as a team player and communicates openly and honestly.
  • Maintains current knowledge of state and federal regulatory requirements to adhere to strict compliance of all aspects Altegra Health's Outreach Operations.
  • Demonstrates behaviors, actions, and attitudes that reflect Altegra Health's vision, mission and values.
  • Performs other duties as assigned.

JOB QUALIFICATIONS 

  • High School Education; Associates Degree preferred.
  • 2 years’ experience with direct consumer interaction, telephone sales experience, Medicaid program experience preferred.
  • Demonstrated application of data entry and related computer skills.
  • Excellent oral communication skills; ability to communicate with elderly individuals and state governmental personnel.
  • Ability to analyze and interpret governmental program criteria; ability to interact and decipher information via telephonic or correspondence inquires.
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