The Enrollment Associate I is intended as MHS entry level position, responsible for analyzing and maintaining accurate membership eligibility and benefit plan information using the different health plan websites to enroll members through MemorialCare Health System application. The Enrollment Associate I works under direct supervision from more senior members of an application support team, and/or IT management. The role is responsible for the accurate and timely response to all member eligibility requests and is accountable for the success of assigned task.
Essential Functions and Responsibilities of the Job
Manage personal queue, issues and tickets in ServiceNow and Workfront: Complete documentation, contract information and follow-up communication once issue is resolved.
Maintain regular user contact and attend relevant meetings, and assists with contact for IS to ensure communication, collaboration, and teamwork. Identify and resolve problems and issues that arise in the application.
Develops and maintains an ongoing awareness of MemorialCare’s healthcare information systems initiatives, emerging technologies, and relevant laws and regulations in providing ongoing and competent support for assigned areas of responsibility.
Complies with all IS Policies, Procedures and Standards including: Project Management tools/methodologies, Network/Systems Workstation Security, HIPAA Privacy and Security Regulations associated with Electronic Protected Health Information (ePHI).
Be at work and be on time
Follow company policies, procedures and directives
Interact in a positive and constructive manner
Prioritize and multitask
Essential Job Outcomes
Manage personal queues, issues or calls from customers for assistance. Complete documentation, contact information and follow-up communication once issue is resolved.
Accurately update member eligibility information by verifying eligibility and benefit information using the various health plan websites. When necessary, communicate with the health plans by asking appropriate questions and being familiar with the terminology used. Effectively navigate through the system of record application to enroll these members.
Resolve routine problems and issues associated with assigned applications to ensure high levels of availability and user satisfaction. Maintain contact with users and senior team members to ensure understanding of needs, assignments, and overall goals.
Adheres to department productivity goal in managing personal queue, issues and tickets in Service Now and Work Front, etc. within the established service level agreement.
Maintains flexibility to undertake new assignments as required to react quickly and positively to changing priorities including but not limited to member demographics update, expired patient, shell coverage clean-up, dual coverage clean-up, Hospice report, and ERISA report.
Work as a team player and communicates in a positive manner with co-workers, managers and other contacts in regards to best practices.
Prioritize work to meet department deadlines and the needs of other departments. Keep supervisor/manager informed of issues pertaining to enrollment.
Participates in education programs, in-service meetings and workshops to enhance professional growth and development.
Participates in regular meetings with users and decision makers to ensure operational approval for all system initiatives.
Perform any additional/miscellaneous duties as requested by the management team within the scope of knowledge/ability.
A minimum of one year experience in a business office environment preferred.
Must possess strong 10-key skills.
Accurate data entry or typing skills necessary.
Basic insurance knowledge required.
Good written and verbal communication skills
High school graduate or equivalent.
Internal Number: MEM003744
About MemorialCare Medical Foundation
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.