Specialist, Enrollment I

Overview

Are you looking for a purposeful career that will make a difference in the patient community? At CCS, our approach to at-home patient care is redefining chronic care management. We are seeking individuals that will thrive in a patient-centric dynamic environment. If you are an attentive listener, fast-thinker, and problem-solver, with the ability to relate to different people, you are a match for CCS. 

As a New Customer Enrollment Representative, assists the Enrollment Sales Specialist function in managing and maintaining overall patient care duties and customer relationships for the department including contacting new patients, establishing and nourishing the relationship with outside sales, provider contacts, and patients to ensure patient records are complete prior forwarding the file as appropriate for shipment.  

The successful candidate will report directly to the department supervisor.   

Alaska, California, Colorado, Delaware, Hawaii, Idaho, Maine, Montana, Nevada, New Hampshire, New York, North Dakota, Rhode Island, South Dakota, Vermont, Washington, Wyoming , Illinois; residents are not eligible.

Responsibilities

• • Referral intake and entry, including validating a referral before entry to ensure compliance and acceptance for CCS Medical current business processes 
  • Routes and saves documentation to patient accounts in PIMS, as required by insurance plan 
  • Verifies insurance in-network status as needed 
  • Updates workflow for reporting purposes 
  • Demonstrates accountability and responsiveness to the needs of the patients 
  • Assist with inbound and outbound calls to potential patients, physicians, and business partners, as needed  
  • Assist with new patient enrollment in other various functions, as assigned 
  • Maintains accurate patient records 
  • Maintains a high degree of confidentiality at all times due to access to sensitive information   
  • Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department 
  • Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements 
  • Abides by all regulations, policies, procedures and standards  

Desired Outcomes

• • Exercises appropriate cost control measures 
  • Maintains positive internal and external customer service relationships 
  • Maintains open lines of communication 
  • Plans and organizes work effectively and ensures its completion 
  • Meets all productivity requirements 
  • Demonstrates team behavior and promotes a team-oriented environment 
  • Actively participates in Continuous Quality Improvement 
  • Represents the organization professionally at all times 

Qualifications

• • High School diploma or GED equivalent  
  • Minimum of 6 months prior call center experience (preferably inside sales and/or account management) 
  • Basic knowledge of billing procedures, insurance reimbursement procedures and HCPC codes preferred 
  • Proficient in Microsoft Outlook, Word, Excel, PowerPoint and computer literacy 
  • Strong knowledge of government payer requirements 
  • Knowledge of commercial insurance payers as it relates to documentation of claims that are required before submission 
  • Ability to understand Medical Records documents  
  • Ability to understand safety rules, operating and maintenance instructions, and procedure manuals 
  • Position may require evening and weekend availability  
  • Strong attention to detail, multi-tasking, communication, and organizational skills are essential 
  • Demonstrated ability to accurately perform data entry and pay close attention to detail

Values

Certainty-The lives of the individuals we serve depend on our ability to execute. We commit to doing this every day.

• Use appropriate methods and a flexible interpersonal style to help build a cohesive and collaborative team based on a foundation of trust and transparency. Deliver what you commit to.

Compassion-We understand the burdens of patients and their loved ones and channel this into a relentless pursuit of customer satisfaction in every part of our business.

• Ensure that the patient is the driving force behind business decisions, implementing service practices that meet the needs of both the patient and the organization. Treat others the way you want to be treated.

Advancement-We are endlessly looking for ways to progress and become more innovative in all things we do.

• Encourage innovative approaches for addressing opportunities and facilitating change, driving cross-functional alignment to accomplish goals. Speak the truth.