Partnership HealthPlan of California · 6 hours ago
Enrollment Specialist I
US-CA-Fairfield
Full-time
Onsite
Entry Level
$28.94/hr - $34/hr
1+ years expPartnership HealthPlan of California is seeking an Enrollment Specialist I to assist in maintaining Medi-Cal membership. The role involves reviewing and resolving eligibility issues, processing PCP assignments, and documenting member records accurately.
Health CareInsuranceNon Profit
Responsibilities
Processes PCP assignments and reports
Reviews and responds to eligibility questions and issues
Processes a variety of membership reports to ensure members records as well as PCP assignments are appropriate
Monitors the E-Unit inbox and processes all Medi-Cal eligibility related questions and requests
Maintains and processes out of area requests
Processes all related newborn add requests etc
Participates in special projects, tasks, and assignments, as needed
Processes duplicates records
Communicates with county contacts to correct membership records, aid codes or other eligibility discrepancies at the county level
Arranges face to face interpreting and reconciles invoices
Processes “no show” appointment requests
Supports and assists team members in their daily duties as needed
Other duties as assigned
Qualification
Required
High School Diploma or equivalent
one (1) year experience in health care or Medi-Cal or Medicaid eligibility
Thorough knowledge of managed care and Member Services Policies and Enrollment Unit procedures
Excellent understanding of all Partnership policies and procedures relating to all aspects of care
Excellent understanding of external agencies that provide services to Partnership members
Strong understanding about the Medi-Cal eligibility process
Working knowledge of business software applications
Proficient use of computer keyboard to access data
Effective written communication skills
Excellent organization skills with ability to prioritize assignments and meet deadlines
Ability to use good judgment within the scope of authority and to handle confidential and sensitive issues with tact and diplomacy
Ability to stay focused on repetitive work and meet production and quality standards
Ability to understand and follow instructions
Must have excellent organization skills and be detail oriented with a high level of accuracy
Ability to lift, carry, or move objects of varying size, weighing up to 10 lbs
Ability to use multiple computer monitors, headsets, and keyboard to accomplish tasks
Preferred
Customer service experience
Bilingual skills in Spanish, Tagalog, or Russian
Company
Partnership HealthPlan of California
Partnership HealthPlan of California is a non-profit community-based health care organization that contracts with the state to administer Medi-Cal benefits through local care providers to ensure Medi-Cal recipients have access to high-quality comprehensive cost-effective health care.
1001-5000 employees
Funding
Current Stage
Late StageLeadership Team
L
Lorna Veloso
Sr. Manager of OpEx/PMO
Recent News
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