Specific Skill Set Requirements: Quick learner, previous enrollment experience preferred. Promptly and effectively process all enrollment requests in compliance with all regulatory requirements and accreditation standards. This includes timely entry and maintenance of data after review and analysis of electronic and hard copy information. Facilitate problem resolution through investigation and collaboration as needed
Job Summary:
Promptly and effectively process all enrollment requests in compliance with all regulatory requirements and accreditation standards. This includes timely entry and maintenance of data into Facets after review and analysis of electronic and hard copy information. Facilitate problem resolution through investigation and collaboration as needed.
Essential Functions:
Process enrollment requests in a timely and accurate manner in compliance with state and federal regulations and accreditation standards.
Audit enrollment files consistently to ensure all are complete, organized, and secure according to policies and procedures
Courteously provide internal and external customers with information and education regarding the government programs enrollment process, eligibility, COBRA and HIPAA regulations.
Maintain an understanding of state and federal requirements and accreditation standards that impact the enrollment process.
Conduct research as necessary to effectively resolve customer issues and respond to customer inquiries in a timely manner. Performs reconciliation work on accounts/cases.
Ensure inventory of enrollments and customer inquiries are resolved within established guidelines. Monitor and maintain data content of membership via various databases.
Maintain general knowledge of other functional areas of the system and PH to better assess impacts on enrollments.
Communicate as required with internal/external customers regarding member enrollment status through Facets documentation, phone calls and written correspondence, including use of approved form letters. Accurately communicate to leader critical customer issues.
Qualifications:
Required High School Diploma or equivalent
Preferred Associate's Degree
2 years of relevant experience Two years of experience in a health related field. Required
Enrollment position preferred. Preferred
Experience with Medicare/Medicaid regulations. Preferred
Compensation:
The hourly rate for this position is between $33.00-$38.00per hour.
Factors which may affect starting pay within this range may include [geography/market, skills, education, experience and other qualifications of the successful candidate].
Benefits:
Sunrise offers ACA compliant medical coverage/dental insurance/vision insurance to all employees. We also offer Sick time benefits as required per State regulations
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Skills
Accreditation Standardsunmatched
Analysis Skillsunmatched
COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985)unmatched
Documentationunmatched
Federal Laws and Regulationsunmatched
File Auditsunmatched
Governmentunmatched
HIPAA (Health Insurance Portability and Accountability Act)unmatched
High School Diplomaunmatched
Medicaidunmatched
Medicareunmatched
Multitaskingunmatched
Organizational Skillsunmatched
Problem Solving Skillsunmatched
Reconciliationunmatched
Regulationsunmatched
Regulatory Complianceunmatched
Regulatory Requirementsunmatched
Research Skillsunmatched
Resolve Customer Issuesunmatched
State Laws and Regulationsunmatched
Time Managementunmatched
About Company
Sunrise Systems was founded in 1990 with a clear vision to deliver world-class staffing service solutions in all labor categories, including IT consulting and solutions; all with the commitment to provide service that exceeds expectations and become the most trusted name in the industry. More than two and a half decades later, we pride ourselves on being at the forefront of the staffing industry. Combining our deep industry expertise, insights, and global resources, we have partnered with our clients to connect them with top professionals across several different industries.
We provide cost-effective Managed Staffing Solutions, Information Technology and Information Technology Consulting Services to several Fortune 500 companies and U.S. Government agencies. We provide our clients with flexible engagement models and customized products that are budget and time specific. Understanding the challenges that every business faces, we offer our services either on-site at the clients' site or from one of our globally distributed technology centers. Our onshore and offshore development capabilities ensure that we excel at meeting customer requirements every single time.
Our collective business experience spans over two and a half decades and ranges from:
Business, management, and technical fields
Information technology consulting and software solutions.
Providing strategic support for the development and long-term growth of new business ventures across several industries including but not limited to; accounting, banking, finance, and recruitment.
Motivating technology staff and establishing partnerships with Fortune 500 companies
Sunrise Systems has a vast range of competence in:
Design, development, and support of cloud-based solutions from simple to highly complexed
Database administration of multi-platform applications, complex databases, and web-based environments that include all aspects of installation, planning, maintenance, and monitoring.
Data processing and data migration
Application re-engineering and platform migration
Working with the Information Systems and end-user communities at all levels to resolve issues and establish consensus.
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