Enrollment Specialist

This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793. Only applicable for San Francisco Candidates : Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Pride Health is hiring a Enrollment Specialist to support our client's healthcare facility in Marshfield, WI
 
Job Details: 
Schedule:  Monday–Friday, 8:00 AM–5:00 PM with a 1-hour lunch
Location:  Marshfield, WI
Job Type: Contract
Contract Length: 13 weeks of Contract 
Pay Range: $20.00 to $25.85/hour

*Pay offered is based on experience, expertise, credentialing, and education.  
 
Duties: 

• Provide accurate and timely answers to questions regarding benefits, coverage, premiums, and claims by telephone and in person.
• Assist with coordinating out-of-area or non-affiliated provider referrals for members requiring care outside the service area.
• Answer Centers for Medicare and Medicaid Services (CMS) test calls accurately and timely to ensure compliance with CMS guidelines.
• Assist Federally Facilitated Marketplace (FFM) members with updating financial and subsidy information in accordance with federal requirements and the Affordable Care Act (ACA).
• Document member interactions electronically to ensure records are accurate and available for future use.
• Utilize electronic systems to verify and assist members with wellness benefit questions and reimbursement.
• Troubleshoot online portal and secure email issues to help members access and view information electronically.

Requirements: 

• Education: High School Diploma or equivalent required.

Experience 

• Minimum 2 years of customer service experience required.
• Strong background in call center, medical, or insurance environments preferred.
• Health insurance call center experience preferred.
• Demonstrated ability to handle high-pressure situations.
• Strong verbal and written communication skills.

Skills/Specialties/Technology

• Customer Service
• Call Center Experience
• Health Insurance
• Medical Insurance
• Claims
• Benefits & Coverage
• Premiums
• Medicare/Medicare Advantage
• Medicaid/CMS
• ACA/FFM
• Member Support
• Complaint & Grievance Resolution
• Telephone Customer Service
• Data Entry & Documentation
• Online Portal Troubleshooting
• Strong Verbal & Written Communication

Interested? Apply Today! For workers in the United States, PrideGlobal and it's affiliates offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, pet insurance and employee discounts with preferred vendors.

Equal Employment Opportunity
PrideGlobal and it's affiliates are an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.

Fair Chance Employment
PrideGlobal and it's affiliates are a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.

Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require a reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.

Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.

Only applicable for Kentucky positions: For this type of employment, state law requires a criminal record check as a condition of employment. This applies to direct care staff (Examples: RN, LPN, Nurse Aides, Therapists) referred to Kentucky nursing facilities, assisted living communities, or long-term care facilities, in accordance with KRS 216.793.