Solis Health Plans · 5 hours ago
Enrollment Specialist
Doral, FL, US
Full-time
Onsite
Entry Level
$21/hr - $23/hr
1+ years expSolis Health Plans is a healthcare organization seeking an Enrollment Specialist to manage the processing of new enrollment applications and updates to member profiles in compliance with CMS and state regulations. The role involves auditing data, communicating with Medicare beneficiaries, and ensuring compliance with various healthcare laws.
Health CareHealth DiagnosticsPersonal Health
Responsibilities
Handles receiving, controlling, and processing enrollment and disenrollment elections from Medicare beneficiaries, as well as any required updates to a member record
Audits data entered into the plans internal systems to ensure data integrity and quality
Uses judgment and informed decision-making to determine appropriate actions on elections and in handling discrepancies
Transmits election information to CMS within specified timeframes and according to CMS regulations
Ensures appropriate letters are sent to members within CMS timeframes
Conducts outbound calls to confirm and verify mailing addresses, permanent residency
Sorts returned mail and prepares mail with corrected addresses
Analyzes and interprets out of area indicator reports submitted by CMS and determine action to be taken
Places materials into storage receptacles, such as file cabinets, boxes, bins, or drawers, according to classification and identification information
Reads and scans all incoming materials to determine how and where they should be classified or filed
Sorts or classifies information according to guidelines, such as content, purpose, user criteria, or chronological, alphabetical, or numerical order
Eliminates outdated or unnecessary materials, destroying them or transferring them to inactive storage, according to file maintenance guidelines or legal requirements
Performs periodic inspections of materials or files to ensure correct placement, legibility, and proper condition
Input data, such as file numbers, new or updated information, or document information codes into computer systems to support document and information retrieval
Communicates effectively with other professional and support staff in order to achieve positive customer outcomes
Promotes and contributes to a positive, problem-solving environment
Assists customers, family members and others with concern and empathy; respect their confidentiality and privacy and communicate with them in a courteous and respectful manner
Complies with company policies and procedures and maintains confidentiality of customer medical records in accordance with state and federal laws
Ensures compliance with all HIPAA, OSHA, and other federal, state, and local regulations
Participates in meetings, training and in-service education, as required
Performs other duties as assigned
Qualification
Required
High school graduate or equivalent and one (1) year Medicare, Medicaid, managed care or other health/insurance related experience; or equivalent combination of education and experience
Data entry skills a must
Excellent organizational skills, customer service skills, listening, interpersonal, verbal and written communication skills with individuals at all levels of the organization
Excellent computer knowledge is required, including proficient knowledge of Microsoft Office
Familiarity with healthcare laws, regulations, and standards
Working knowledge of the Privacy and Security Health Insurance Portability and Accountability Act (HIPAA) regulations
Ability to continually display a positive attitude and follow directions
Ability to multi-task, prioritize, carry out tasks thoroughly, and meet deadlines
Must be patient in dealing with an elderly population and sympathetic to hearing or vision deficiencies
Ability to work effectively independently and in a team environment
Ability to read, analyze, and interpret technical procedures or governmental regulations
Ability to write reports, business correspondence, and procedure manuals
Ability to effectively present information and respond to questions from groups of managers, clients, customers and the general public
Ability to calculate figures and amounts, such as discounts, interest, commissions, proportions, percentages, area and volume
Ability to define problems, collect data, establish facts, and draw valid conclusions
Strong decision-making, analytical skills
Must be self-motivated, organized and have excellent prioritization skills
Must be able to work well under stressful conditions
Must be able to work in a fast paced environment
Fluency in Spanish and English required
Company
Solis Health Plans
Solis Health Plans is a medicare firm that deals with healthcare solutions and plans.
51-200 employees
Funding
Current Stage
Growth StageLeadership Team
Efrain Duarte
Chief Executive Officer
Michael Lynch
Chief Financial Officer
Recent News
2025-04-15
Company data provided by crunchbase