ABOUT US

Join us in making a career in Independent Living Systems, an industry leader in managing home and community-based programs for over 20 years. Independent Living Systems, LLC and its subsidiaries offer a comprehensive range of clinical and third-party administrative services to managed care organizations and providers that serve high-cost, complex member populations in the Medicare, Medicaid, and Dual-Eligible Market. ILS provides tailored integrated solutions aimed at improving health outcomes while rebalancing costs, addressing social determinants of health and connecting members with community-based resources.

Position Summary

Independent Living Systems is committed to enhancing quality of life through innovative health and support solutions that reduce costs, foster independence, improve compliance and enhance coordination of care. The Enrollment Specialist is responsible for accessing, review, process all member authorizations and create member records in eCare, ILS proprietary data management system. The Specialist ensures the timeliness and accuracy of all documentation and member records.

Essential Functions:

1. Retrieve and process all member authorizations in a timely and accurate manner.
2. Create member records in eCare that are complete and accurate, according to the established workflows.
3. Monitor Managed Care Plan (MCP) portals to identify new referrals (authorizations) to ILS.
4. Complete the accurate transfer of information in preparation for systems upload.
5. Initiate contact with Managed Care Plans (MCP) and follow up on authorization requests; identify and escalate issues as they may arise throughout the process.
6. Respond to Contracted provider and MCP inquiries and research authorization status and assignments in eCare.
7. Review and correct data entry errors 
8. Review and work daily task list to ensure prompt processing and closure of authorization requests.
9. Create new authorizations for referrals to contracted providers and ensure timely outreach based on established protocols and program guides.
10. Create and maintain spreadsheets with large amounts of data accurately.
11. Store electronic copies of original data in an organized manner to optimize retrieval for quality review.
12. Conduct a detailed review of multiple data sources to reconcile data each day.
13. Comply with documentation requirements in a timely and accurate manner.
14. Assist with contacting members by phone to schedule an initial visit, following prescribed scripts, when requested.
15. Conduct member outreach calls and schedule assessments
16. Assign members to the appropriate provider or ILS team member.
17. Respond quickly to provider calls to resolve authorization related issues.
18. Maintain effective and timely communication with team members, supporting a supportive and productive work environment.
19. Ensure that all interactions with members and providers are conducted within the ILS guidelines, including workflows, policies & procedures(P&Ps), scripts, and timelines.
20. Refer issues to supervisor according to workflows.
21. Respond appropriately (as specified in workflows and P&Ps) to emergencies.
22. Fully utilize available technology and electronic systems
23. Attending scheduled meetings, training sessions, etc.
24. Convey any member-related urgent issues to the Supervisor or Director
25. Maintain a high level of confidentiality with sensitive client information.
26. Participate in special projects.
27. Maintain customer service and productivity standards.
28. Perform other duties as assigned.

Education and Experience

• High School Diploma or GED required. 
• Some higher education is preferred. Typing of 80 WPM.
• Some data entry, office administration, and/or other related experience preferred\
• Knowledge of managed health care is an asset.
• Superb attention to detail.
• Microsoft Office Platform proficiency; and a basic understanding of databases. 

EEO STATEMENT 

In compliance with the Drug-Free Workplace Act of 1988, Independent Living Systems has a longstanding commitment to provide a safe, quality-oriented, and productive work environment. Alcohol and drug abuse pose a threat to the health and safety of ILS employees and to the security of the company's equipment and facilities. For these reasons, ILS is committed to the elimination of drug and alcohol use and abuse in the workplace. Independent Living Systems, LLC, and its subsidiaries, including FCC, provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, disability, ancestry, or any other characteristic protected by state, federal, or local law. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.