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Enrollment Specialist II

Professional Management Enterprises
United States, Indiana, Indianapolis
9245 North Meridian Street (Show on map)
Mar 12, 2025
Job Description: Process work items according to appropriate regulatory guidelines Interpret data, analyze results using statistical techniques Completion of daily and monthly pre-processor exceptions in an accurate manner and in accordance with stated service level agreements. Analyze member eligibility and take appropriate actions to resolve issues across all eligibility systems Completion of all daily and monthly eligibility loading reports in an accurate manner and in accordance with stated service level agreements Identify, analyze, and interpret trends or patterns in complex data sets Process mass Primary Care Physician (PCP) changes with Provider Operations Research and respond to eligibility inquiries from contracted vendors Filter data and review reports to locate and correct code problems in the pre-processor Process paper applications received for all applicable lines of business Inbound phone coverage to answer inquiries from both internal and external customers Make outbound phone calls in support of Enrollment processes Work closely with management to prioritize business needs Locate and define new process improvement opportunities Complete all required corporate training within stated timelines to a satisfactory manner Access state and federal government systems to review and confirm eligibility status Subject Matter Expert for the line of business they are supporting Perform any other job-related instructions, as requested 3-month contract assignment / Fully remote 40-hour weeks / Weekly Pay Education/Experience: High School Diploma or equivalent required Associate's degree in accounting, finance or business-related field or equivalent work experience is preferred Minimum of three (3) years of healthcare, insurance, or related industry experience to include at least two (2) years of enrollment/eligibility or similar experience is required Required Skills: Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy Strong knowledge and experience of Microsoft Word and Excel Excellent verbal and written communication skills Ability to work independently and within a team environment Attention to detail Strong knowledge of the healthcare field Strong knowledge and experience of Medicaid and Medicare preferred Critical listening and thinking skills Proper grammar usage Time management skills Proper phone etiquette Customer service oriented Multitasking skills Critical Thinker/problem solver