Salary

$18.00 - $21.00 / Hour

Overview

Elderwood Health Plan is currently seeking an Enrollment Coordinator to join our team as a valued colleague.

This is a full time, hybrid position requiring 2-3 days in office located in Buffalo, NY (Larkin District). Growth & advancement opportunities available for those seeking a career track.

Elderwood Health Plan Overview:

Elderwood Health Plan is a Managed Medicaid plan where our mission is to provide services to seniors in the community or returning to the community. We have developed a premier provider network and employ a staff of care management professionals to help our members stay at home or return safely to home.

Position Summary:

 

The Enrollment Coordinator provides assistance and education to potential members and their families and facilitates MLTC plan membership. This individual reviews applications submitted to the Local Departments of Social Services (LDSS) and Maximus, tracks progress and resolves challenges, screens new candidates, and identifies eligible consumers related to both long-term care needs and Medicaid.

Join Our Team

Are you looking to take the next step in your career?

Employee Perks!

401K Retirement Plan with Company Match, Close to thruway entrances/exits, Conveniently located on a bus route, Free On-Site Parking, Friendly and supportive staff, Generous PTO & holiday package, Life Insurance, Medical, Dental, and Vision insurance, Relaxing employee lounge with free iced/hot coffee, Strong leadership, Substantial employee referral program

Responsibilities

Enrollment Coordinator:

• Receives and addresses inquiries via phone/email; answers product and/or service questions.
• Generates leads through community engagement (i.e. events, provider engagement, etc.) to maintain a referral flow for plan census growth.
• Completes all necessary paperwork, documentation, and follow-up as required (i.e. enrollment application, lead reports, outreach logs, scheduling and other administrative work).
• Establishes contact, assesses individual's needs and concerns, establishes eligibility, provides overview of organizational mission, effectively and clearly presents benefits of products in accordance with all governmental regulations.
• Increases/maintains plan census through conducting individual client screenings to assess for Medicaid funded Long Term Care eligibility, following up with State Brokers to ensure proper handling of the Medicaid MLTC application process, and facilitating New York Independent Assessor appointments for evaluations for MLTC enrollment.
• Provides potential members and their families with education regarding the MLTC model of care.
• Processes all incoming communication from interested parties for potential enrollees.
• Troubleshoots problems that require interpretation of administrative and/or technical issues.
• Facilitates referrals for Medicaid applications.
• Maintains knowledge of Medicaid eligibility requirements (i.e. restriction codes, income limits, spenddowns, Pooled Trust eligibility, and waiver programs).
• Completes pre-enrollment screening form for all potential enrollees.Works with EMR and State Electronic Systems (i.e ePACES, Health Commerce System, UAS-NY, Maximus Secure Portal) for new enrollment management.
• Educates potential enrollees on plan benefits and provider network, and maintains knowledge of all covered and non-covered services for the MLTC program and additional State programs available to consumers (i.e. PACE, MCO, and waiver programs)
• Accurately and effectively tracks all enrollment and disenrollment information and communicates timely with EHP billing department.
• Ensures that all enrollment and disenrollment activities are documented accurately in the member electronic health record.
• Communicates with RN Care Managers and outside vendors regarding scheduling of consumers assessment.
• Processes submission of all potential enrollments/disenrollments to the New York State broker MAXIMUS.
• Maintains relationships with referral sources and community resources to increase and maintain referrals, including consumer update communication and regular meetings to ensure future referrals for census growth.
• Travels occasionally to potential member’s homes and community outreach events.
• Obtains and determines the accuracy of Plan enrollment documents to ensure compliance with all governmental regulations. Works with consumers and their designated representatives until all documentation is completed accurately and is on file with the plan.
• Maintains knowledge of and successfully implements New York State MLTC policies, regulations, and guidance to process consumers for enrollment.
• Utilizes electronic timekeeping system as directed.
• Arrives to work on time, regularly, and works as scheduled.
• Recognizes and follows the dress code of the facility including wearing name tag at all times.
• Follows policy and procedure regarding all electronic devices, computers, tablets, etc.
• Supports and abides by EHP’s Mission, Vision, and Values
• Abides by EHP’s businesses code of conduct, compliance and HIPAA policies.

From

USD $18.00/Hr.

Up to

USD $21.00/Hr.

Qualifications

Enrollment Coordinator:

• Minimum of associates degree (bachelors preferred)

• Demonstrated knowledge of Medicaid product information

• Basic understanding of health diagnoses and verbiage

• Demonstrated proficiency with Microsoft Office

• Current, valid NYS driver’s license

• Experience within insurance field, managed care or customer service preferred

• Bilingual English/Spanish speaking preferred

• Elderwood expects all current and new employees to be vaccinated against COVID-19. If hired, you will be required to provide proof of vaccination. Employees may request a medical or religious exemption from vaccination.

Enrollment Coordinator Skills/Competencies:

• High attention to detail and accuracy
• Highly organized
• Displays high level confidentiality and privacy especially handling sensitive client information
• Excellent communication skills both verbal and written
• Excellent customer service skills
• Able to communicate effectively with individuals with different primary languages, backgrounds, and abilities
• Strong problem-solving ability

EOE Statement

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.