25 Jan
Medicaid Enrollment Specialist (REMOTE)
South Carolina, Charleston , 29492 Charleston USA

Vacancy expired!

It’s Time For A Change…Your Future Evolves HereEvolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.Are we growing? Absolutely – about 40% in year-over-year revenue growth in 2018. Are we recognized? Definitely. We have been named one of “Becker’s 150 Great Places to Work in Healthcare” in 2016, 2017, 2018 and 2019, and one of the “50 Great Places to Work” in 2017 by Washingtonian. We recognize employees that live our values, give back to our communities each year, and are champions for bringing our whole selves to work each day. If you’re looking for a place where your work can be personally and professionally rewarding, don’t just join a company with a mission. Join a mission with a company behind it.What You’ll Be Doing:Essential FunctionsMaintain accurate member records. Enter eligibility and/or enrollment data into Aldera system on a daily basis including new enrollees, change in circumstance terminations, PCP’s, broker and other information.

Review 834 X12 files during the Aldera system load process. Research and work any discrepancies or errors.

Adjust premiums and rates for financial billing.

Resolve client and internal ticket requests.

Correspond and communicate with the groups, brokers, and clients through tickets, workflows and emails.

Meet minimum daily production requirements and produce high-quality work consistently.

Generate and/or work reports (daily, weekly, monthly.)

Adhere to existing and new policies and procedures specific to each client.

All other duties as assigned.

Education and ExperienceHigh school diploma, 4 year college degree or equivalent experience required.

Medicaid policy and EDI knowledge preferred.

Experience coordinating with healthcare clients and/or payers to execute enrollment related activities.

Interpersonal skills to work well within a team that includes all levels within the organization from clerical and support staff to senior management as well as clients and brokers outside of the organization.

Ability to work independently, prioritize and work under deadlines. Attention to detail.

Understands and can work in a production environment in which performance is tied to operational metrics.

Integrity and discretion to maintain confidentiality of member’s HIPAA data.

Proficient in Microsoft Office (Outlook, Excel, Word.)

Technical requirements:Currently, Evolent employees work remotely temporarily due to COVID-19. As such, we require that all employees have the following technical capability at their home: High speed internet over 10 MBPS and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.Evolent Health is committed to the safety and wellbeing of all its employees, partners and patients and complies with all applicable local, state, and federal law regarding COVID health and vaccination requirements. Evolent expects all employees to also comply. We currently require all employees who may voluntarily return to our Evolent offices to be vaccinated and invite all employees regardless of vaccination status to remain working from home. Certain jobs require face-to-face interaction with our providers and patients in client facilities or homes. Employees working in such roles will be required to meet our vaccine requirements without exception or exemption.Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.Compensation Range: The typical range of employees within the compensation grade of this position is . Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.

Vacancy expired!


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