Enrollment Specialist

  • Salary

    $15 Per Hour


2 to 3 Years

Posted On

Nov 08, 2023


TechVilla Solutions

Work Arrangement


Job Overview

Required Skills

  • Enrollment
  • Health Plan
  • Medicare
  • DTRR
  • MMRs

Job Type

Contract - Independent, Contract - W2


St. Louis, MO/ Dallas, TX

Travel Requirements


Job Description

Roles & Responsibilities:

1. Essential Functions-

  • Enter enrollees into system monthly
  • Submit Enrollment Files to CMS monthly
  • Place enrollment file on FTP site monthly
  • Check DTRR reports daily
  • Follow-up on any issues appearing on the DTRR
  • Place MMR in Excel on FTP site
  • Submit MMRs, HCC MORs & Rx HCC MORs to PDAC monthly
  • Submit retroactive adjustments to Reed & Associates or CMS regional office as needed
  • Submit attestation information to clients monthly
  • Completes Enrollment Data Validation (EDV) Audits
  • Follow up on enrollment issues
  • Communicate any outstanding enrollment issues to clients
  • Review the A/R aging each week
  • Coordinate follow-up with the Accounting department for any A/R balances

2. Additional Functions-

  • Assists with special projects, as requested
  • Communicates clearly and concisely, with sensitivity to the needs of others
  • Maintains the confidentiality of all company procedures, results, and information about participants, clients, providers and employees
  • Maintains courteous, helpful and professional behavior on the job; displays a willingness and ability to be responsive in a warm and caring manner to all customer groups. Consistently cooperates and supports organization in problem solving issues.
  • Establishes and maintains effective working relationships with co-workers
  • Follows all Policies and Procedures and HIPAA regulations
  • Participates in any recommended or required training sessions
  • Maintains a safe working environment

Knowledge, Skills and Abilities:

  • Educational requirements include a high school diploma or equivalent. 
  • Three years of experience in a health plan management or insurance company, or similar experience, is required. Prior experience working with enrollments is strongly preferred. A working knowledge of Medicare is required.
  • Current knowledge and understanding of Medicare regulations related to PACE health plan management is helpful.
  • Knowledge and experience using Excel, Microsoft Word and ten-key efficiency; ability to quickly adapt to new systems
  • Strong knowledge of current computer technology, including the use of computers, printers, computerized file structures and associated software
  • Skilled in establishing and maintaining effective working relationships with co-workers and clients
  • Skilled in problem resolution; recommends suggestions to increase accuracy and/or efficiency
  • Detail-oriented with ability to focus on projects for extended periods
  • Ability to work independently, seeking supervision as needed
  • Ability to communicate professionally, clearly and effectively, verbally and in writing
  • Ability to have superior attendance to effectively fulfill all functions of the position
  • Ability to independently follow through on assigned tasks, without prompting
  • Ability to prioritize effectively
  • Ability to consistently multitask

Job ID: TS230280

  • Posted By

    James William


Sr. HR


Techvilla Solutions

Last Login

Jun 14, 2024

Posted On

Nov 08, 2023

Related Jobs