CareSTL Health
  • 01-Nov-2018 to 31-Jan-2019 (CST)
  • Operations
  • St. Louis, MO, USA
  • Hourly
  • Full Time

Medical, Dental, Vision, 403B, STD/LTD, PTO


CareSTL Health seeks a full-time Eligibility Enrollment Representative to assist consumers with enrollment and maintaining active insurance coverage, verifying continuing eligibility and benefits with various health plans, develop relationships with health plan service providers, manage monthly reporting and facilitate health care and social service resources to support consumers of the health center services.

 

Duties:

  • Ensure patients health care benefits are active and covers required procedures.
  • Educate patients on coverage levels and out of pocket expenses; obtain authorizations as needed.
  • Conducts interviews based on care coordination referrals, insured status and needs assessment.
  • Manages transportation services and assist consumers with enrolling in health plan offerings and others services, sample program(s) and/or service initiatives:
  • MoHealth Net pre-eligibility screening
  • Gateway to Better Health eligibility screening and enrollment
  • Global Authorization (prenatal service users)
  • Temporary Medicaid (prenatal service users)
  • Affordable Care Act Marketplace assist and enrollment
  • Consumer navigation activities
  • Health services appointment scheduling
  • Consumer medical visit transportation assistance
  • Consumer emergency transportation assistance
  • Tracks enrollment activities  and provide monthly reports
  • Maintain confidentiality and ensure routine adherence to all regulations surrounding HRSA, CMS, MPCA.
  • Makes outreach calls to health plan members or uninsured population as needed.
  • Maintain flexible availability to organize or attend community events and health fairs as assigned.
  • Acts as a liaison between consumer and all relevant professionals, programs, and resources.
  • Returns phone calls and email communications within 24-48 hours.
  • Maintain client records and update information as necessary.
  • Sets and follows appropriate deadlines and resolve consumer issues within a timely manner.
  • Bridges communications and information between health plan members and health care delivery systems

 

A Successful Candidate:

  • Ability to type at least 30 words per minute
  • Ablility to use office equipment (i.e. telephones, and fax machines)
  • Working knowledge of computers, including Microsoft Office software.
  • Ability to perform basic mathematical calculations
  • Ability to maintain and protect patient confidentiality
  • Ability to work well with other team members and to promote a positive work environment

 

Qualifications:

  • Education:  High School Diploma or GED required. Bachelor's Degree preferred.
  • Experience: 1-2 years Customer Service Experience required. Experience working in a clinical/medical environment is preferred. Experience working in with health insurance enrollment and a background in a clinical/medical environment is preferred
  • Other:  Must have reliable transportation and able to travel up to 10%.
CareSTL Health
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