Enrollment Specialist Job Description

Enrollment Specialist Job Description

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Enrollment specialist provides knowledge in inventory control systems, data entry, electronic packing, shipping and receiving, and computer data entry.

Enrollment Specialist Duties & Responsibilities

To write an effective enrollment specialist job description, begin by listing detailed duties, responsibilities and expectations. We have included enrollment specialist job description templates that you can modify and use.

Sample responsibilities for this position include:

Establishes, maintains, and constantly reviews the accuracy of Medicare, Medicaid, CSHCN, Texas Health Steps, and Railroad Medicare provider billing numbers for providers
Completing data entry
Create and ongoing data integrity of each school within K12’s enrollment systems (SFDC, TotalView, and SAMS)
Following established enrollment procedures and sound practice directly, prepares applications for all new providers for multiple contracts sites, payors and states requiring an acute attention to detail, accuracy and knowledge of complex and varied requirements
Adhere to and comply with information systems security
Process Medicaid and/or Medicare enrollment requests in a timely and accurate manner in compliance with state and federal regulations and accreditation standards
Facilitates the enrollment and initiation visit of the client’s Medicare CCM-eligible patient population onto the proprietary platform, and delivers care to enrolled patients
Capable of coordinating larger / "more complex" enrollment events for clients with more sophisticated requirements and integration
Updating member demographic information and entering in the new information into their internal database
Promptly process member initiated enrollment change requests that come through our Customer Service and Sales teams

Enrollment Specialist Qualifications

Qualifications for a job description may include education, certification, and experience.

Licensing or Certifications for Enrollment Specialist

List any licenses or certifications required by the position: BLS, CPCS, NAMSS, NCQA, CPR, CAQH

Education for Enrollment Specialist

Typically a job would require a certain level of education.

Employers hiring for the enrollment specialist job most commonly would prefer for their future employee to have a relevant degree such as Associate and Bachelor's Degree in Education, Business, Associates, Human Services, Graduate, Nursing, Business/Administration, Management, Healthcare, Communication

Skills for Enrollment Specialist

Desired skills for enrollment specialist include:

Word processing
Systems
Tools used in the department
Workflow
Healthcare delivery
Applicable regulations
Medicare
Complex and varied requirements
Data base experience and other computer related skills
Data entry

Desired experience for enrollment specialist includes:

Process eligibility and billing data correction requests that come from Eligibility Analysts and Associates
Shift is M-F from 8a-5pm (please be available for OT and working on weekends occasionally)
Assist students, faculty, and staff inquiries in person, via the telephone, and electronically
Create school-specific Compliancy Item documentation using third-party platforms and tools
Serve as the Subject Matter Expert and main Point of Contact on enrollment system configuration and maintenance as it relates to schools and their enrollment requirements
Provide project support for the implementation of new strategies and technologies

Enrollment Specialist Examples

1

Enrollment Specialist Job Description

Job Description Example
Our growing company is looking to fill the role of enrollment specialist. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for enrollment specialist
  • Assist in quantitative analysis of key conversion metrics (lead data, telephony, web, CRM, ) to identify opportunities for improvement
  • Help ensure all enrollment system and project activity is delivered in-line with the agreed strategy and deadlines
  • Serve as a key point of contact for internal teams and external vendors who are providing support on related initiatives
  • Assist in the preparation of presentations to share strategies and findings with senior leadership
  • Participate in regularly scheduled meetings related to projects and document discussion points and action items
  • Coordinates the maintenance of the division contract database
  • Strong computer skills in Microsoft Word, Excel and databases
  • Ability to work with high volume enrollments
  • Manage home office operations and operation associates
  • Delegate duties among home office staff and contract/temp employees
Qualifications for enrollment specialist
  • Self-starter with leadership skills and entrepreneurial spirit, driven by challenge and responsibility
  • Individuality and creativity with enthusiasm for working in a team environment
  • Detail-oriented with strong prioritization skills in a deadline-driven environment
  • Quick learner capable of applying new tools and techniques
  • K12 system (TotalView, SAMS) proficiency
  • Experience with Salesforce CRM tool (particularly K12’s instance)
2

Enrollment Specialist Job Description

Job Description Example
Our company is hiring for an enrollment specialist. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for enrollment specialist
  • Act as liaison between department staff and other home office departments
  • Monitor and manage contract/temp employees schedules and attendance
  • Coordinate enrollment implementation for all cases where AB Enroll is involved
  • Manage case research and assistance for Enrollment Services Management and Enrollment Coordinators as needed
  • Assistance with Enrollment Call Center administration needs
  • Facilitate monthly and weekly reports for clients and brokers based on need
  • Implement and manage case builds on internal platforms, working directly with our internal technology team
  • Work directly with external technology platforms when our internal platform is not used
  • Collect and submit weekly payroll for contract enrollers
  • Help to staff and manage enrollments for both field and call center cases
Qualifications for enrollment specialist
  • Knowledge of relevant sales and marketing tools and techniques
  • Associate degree or minimum 3 years credentialing/enrollment experience in lieu of Associate degree required
  • Knowledge of ERISA and HIPAA regulations desired
  • Recruit and manage new contract enrollers
  • Create and maintain great working relationships with all internal departments
  • Manage and implement calls with internal and external clients
3

Enrollment Specialist Job Description

Job Description Example
Our innovative and growing company is looking for an enrollment specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for enrollment specialist
  • Participate in third party enrollment processing training for division and national enrollment staff credentialing and recruiting staff
  • Identify problems and present recommendations for improvements
  • Track application status and progress throughout the enrollment process for applications processed by the third party
  • Process all government program enrollment requests in compliance with all regulatory requirements and accreditation standards
  • Timely entry and maintenance of data into Facets after review and analysis of electronic and hard copy information
  • Communicate as required with internal/external customers regarding member enrollment status through Facets documentation, phone calls and written correspondence, including use of approved form letters
  • Analyze multiple reports from various internal and external sources to determine and implement appropriate action to reconcile enrollment discrepancies
  • Work within the managed care section to ensure issues related to the enrollment broker (EB) contract are addressed in a timely manner to ensure contract compliance and responsive MCO and member support
  • Communicate with statewide stakeholders to improve care delivered and to address Medicaid programmatic issues
  • Assist with monitoring the EB contractor's performance
Qualifications for enrollment specialist
  • 2 years of prior work experience in voluntary benefits or benefit enrollments preferred
  • Knowledge of enrollment platforms (Selerix, ADP, Allapp, ) preferred
  • Intermediate knowledge of Word, Excel, Access and PowerPoint
  • Bachelor’s Degree in Business/Risk Management or related field preferred
  • Intermediate knowledge of insurance processes and administration
  • Advance degrees and/or degrees in education is a plus
4

Enrollment Specialist Job Description

Job Description Example
Our company is searching for experienced candidates for the position of enrollment specialist. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for enrollment specialist
  • Assist members with issues related to EB linkages and accessing services and document issues so that trends and systemic issues can be tracked, reported, and resolved
  • Process disenrollment requests
  • Work duplicate member reports
  • Process Post-90 Day Transfer Requests
  • Serve as liaison with the HL plans, MMIS, Eligibility and System staff to address questions and complaints related to linkages
  • Prepare, process and maintain new and existing member enrollments and or disenrollment records
  • Reports to and works with the Director of Clinical Operations on an ongoing basis
  • Provide a report to the Director of Clinical Operations on the enrollment activity completed each day and identify activities anticipated for the upcoming office days
  • Support the client point of contact
  • Provide initial training to the practice personnel as agreed upon with the Director of Clinical Operations
Qualifications for enrollment specialist
  • Previous experience working with a database (EMR system, HRIS)
  • Demonstrated ability to research and resolve complex issues
  • Some healthcare insurance experience preferred
  • Two (2) years of contact center experience OR
  • Previous sales experience with proven record of achievement preferred, phone sales experience is a plus
  • Solutions oriented with strong follow up ability
5

Enrollment Specialist Job Description

Job Description Example
Our company is growing rapidly and is looking to fill the role of enrollment specialist. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for enrollment specialist
  • Manage patient enrolled population using platform, triage patient health escalations, and ensure positive patient experience
  • Responsible for identifying client issues and working with Director of Client Services to resolve
  • Aggregate and disseminate patient, user and client feedback to Director of Clinical Operations
  • Performing root cause analysis to determine issues related to member complaints and system errors
  • Maintaining data within various tracking tools related to outcome of research of various issues
  • Reading, understanding, and applying State and Federal Guidance to daily activities
  • Adhering to productivity, quality and compliance expectations
  • Identifying issue trends and opportunities for improvement
  • Support outreach and enrollment activities to participants, family members, representatives, employees, and others through distribution of program materials, individual and group presentations, home enrollment sessions and telephone contacts
  • Explain the roles and responsibilities of PCG Public Partnerships in providing Financial Management services to participants/representatives, including the responsibility for payroll processing and payment, and the responsibility for tax withholding and reporting
Qualifications for enrollment specialist
  • Manage all tools and resources related to the analysis and preparation of the platform that supports the enrollment process including required system/profile/information gathering, requirements analysis, system updates, quality testing, data migration, and resulting deliverables such as delivery of benefit cards
  • Strong interest in education
  • Team player attitude, working closely with all other contact center and K12 personnel
  • Ability to communicate with customers effectively through phone, voicemail, email, chat, etc
  • Ability to multi-task in a fast-paced, results-driven environment
  • Excel and Sales Force Automation (SFA) computer skills

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