As an Enrollment Specialist at HiMS, you will be responsible for serving as initial point of contact for community members inquiring about health services and making appropriate referrals to internal and / or external resources.
You'll also be responsible for timely enrollments and facilitation of initial screening of members per customer contracts.
Essential Duties and Responsibilities :
1. Respond to calls from potential and existing integrated health care members.
2. Verify member insurance eligibility.
3. Perform enrollment and schedule member enrollment appointments in a timely manner.
4. Perform enrollment and eligibility data submission and reconciliation.
5. Provide feedback to improve existing enrollment and eligibility procedures.
6. Maintain productivity and quality standards as directed.
7. Produce scheduled reports for in-house and external agencies.
8. Perform other duties as assigned.
General Requirements :
1. Bilingual English / Spanish
2. Possess a valid Arizona driver’s license.
3. Able to work flexible schedule as needed.
4. Able to positively interact and develop rapport with customers and coworkers.
5. Able to sit for extended periods of time.
6. Demonstrate competency in the following areas.
a. Manual dexterity to keep written documentation.
b. Able to use a personal computer and telephonic communications equipment.
7. Ability to read handwritten and printed documents and records.
8. Ability to perform analysis of information.
9. Ability to move around an office environment.
10. Ability to effectively communicate verbally and in writing.
Education and Training :
High School diploma or GED plus two (2) years full-time data entry experience in membership, claims processing and / or encounters in a managed care or Behavioral health services environment.
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