Nashville, United States
about 1 year ago
Responsible for determining plan eligibility and enrolling members within CMS regulatory guidance.
Work to save members with incorrect/incomplete applications by performing customer, physician and/or agent outreach and using support tools. Maintain member demographic update and membership revalidation and apply eligibility requirements for membership changes.
Research and respond to eligibility inquiries as needed.
Ensures all enrollment eligibility is reconciled and maintained in accordance with CMS anddepartmental guidelines, requirements, regulations, policies, and procedures.
Day to Day Activity
A typical day in this position involves reviewing incoming applications, keying information into systems, determining eligibility, and saving submissions as needed.
Phone calls to potential customers and Medicaid systems will be made as needed throughout the day.
In addition to phone calls, websites will be reviewed to gather additonal information on enrollees.
Interviews Phone Screens and then onsite interviews hosted like a job fair