Description
The Enrollment Specialist is the primary point of contact for Mosaic patients with insurance applications and eligibility requirements with state and/or federal insurance programs, including Oregon Health Plan. This includes contacting patients for re-enrollment and assisting the Billing Department with insurance verifications. The Enrollment Specialists will conduct Outreach activities with community partners and other organizations to provide information and enrollment assistance. This position will develop and maintain statistical enrollment reports and manage reports provided by the organization for enrollment and re-enrollment. This position will travel throughout the region to support enrollment assistance. Additionally, this role will be handling pre-registration and registration pre verification for all patients at Mosaic, new or established. Entering, auditing, educating, and advocating for accurate registration in the patient's electronic medical record (EHR). This role identifies patients who have termed from Medicaid/Medicare. When termed, reaches out to patients to inquire as to why they termed and assists patients in navigating the Enrollment process. Provides education on Medicaid eligibility and sliding scale eligibility. Bi-lingual in Spanish/English strongly preferred.
Patient Enrollment
Aid and process state and/or federal applications for insurance coverage for patients and community members.
Troubleshoot application questions or concerns from patients and community members.
Serves as a liaison between state/federal systems and patient, providing timely follow-up and processing of applications and insurance eligibility status.
Timely documentation of all assistance including insurance eligibility status in the electronic medical record (EMR) per procedure.
Outreach
Monitor enrollment reports to identify enrollment assistance needs.
Active patient outreach to capture patient eligibility status at patient visit.
Community outreach to educate and assist community members with enrollment needs.
Customer and Access Services
Advise patients of their Enrollment status with Medicaid/Medicare and aid as needed
Advise patients of financial and/or insurance documentation required for appointments as well as educate patients on different payment options offered
Scheduling
Schedule patients in Enrollment appointments as needed
Provide system or clinic support for New Patient and Enrollment scheduling, rescheduling, and cancellations
Confirm patient demographics, registration, and insurance information and update EHR as needed
Promote and educate, MyChart use
Pre-Registration
Create new patient records in EHR
Patient activation and education on use and benefits of MyChart
Complete the patient registration process and document in the EHR
Educate patients on FPL, Medicaid, and Marketplace requirements as well as assisting with over the phone support when possible
Registration Pre-Verification
Auditor of patient charts to ensure accurate financial registration
Updates patients charts to ensure accurate financial registration including coverage's, guarantors, demographics, annual incomes, and any other registration field that needs correcting
Reaches out to patients to get updated corrected information for accurate financial registration
Works with billing and site supervisors to coordinate needed paperwork and forms for patients
Working in basket messages relating to registration updates, Medicaid eligibility, and sliding scale eligibility
Skills & Knowledge
Working knowledge of health insurance plans including Medicaid and Medicare. Excellent oral and written communication skills, including effective communication with patients on complex or technical information regarding insurance coverage. Ability to develop and present effective presentations in different location settings and group size. Ability to prepare basic correspondence and simple reports in Microsoft Word and Excel. Ability to create, send and manage email in Outlook. Ability to access and use web-based applications and EMR program. Understanding of healthcare navigation including insurance @types, concepts, terminology, billing, and/or regulations required. Knowledge of standard office policies and procedures. Knowledge of Microsoft Office software products preferred. Computer literacy and typing skills. Training in Marketplace enrollment preferred. Knowledge of standard office machines including copier, fax, shredder, multi-line telephone, printers, etc. Excellent customer service skills and ability to effectively and respectfully handle dissatisfied patients. Bi-lingual in Spanish/English strongly preferred.
Who We Are
Mosaic Community Health prides itself on being an innovative health system that pioneers unique and creative ways to provide and improve patient access to health care. Since our founding in 2002 we have proudly served insured and uninsured patients regardless of age, ethnicity, or income.
We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way. At Mosaic Community Health, you will work with incredibly dedicated and mission-centered peers and be part of a dynamic team based environment.
Mosaic Community Health offers more than just a job, it is a lifestyle. A lifestyle of serving others. A lifestyle of being an integral part of your community. A lifestyle that offers work/life balance. A lifestyle of enjoying the outdoors! Central Oregon offers over 300 days of sunshine a year, so enjoy a PTO day on the mountain, biking/hiking trails, or the river! A lifestyle that improves lives, including yours. Of course, we also offer a great benefit package!
Qualifications
Education
Required
High School/GED or better
Experience
Required
0-2 years: 0-2 year(s) of related experience in healthcare and/or social services.
Equal Opportunity Employer
This employer is required to notify all applicants of their rights pursuant to federal employment laws.
For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.
