Enrollment and Eligibility Specialist

PHILADELPHIA, PAPosted 22 days ago

Job summary

• Job post source

  This job is directly from AbsoluteCare

• Job overview

  The Enrollment and Eligibility Specialist at AbsoluteCare plays a crucial role in supporting members and care teams by managing enrollment and eligibility processes to increase member retention and prevent coverage lapses.

• Responsibilities and impact

  The specialist confirms patient eligibility and PCP assignments, assists members with Medicaid/Medicare recertification, monitors eligibility changes, coordinates with care teams for disenrollment, and serves as the subject matter expert on state and payer eligibility requirements.

• Experience and skills

  The role requires a high school diploma (Bachelor's preferred), at least 1 year of experience with Medicaid, Medicare, or health plan eligibility, experience serving complex healthcare populations, and proficiency in Microsoft Office and electronic medical records.

• Work environment and culture

  The position promotes AbsoluteCare's mission, vision, and values, offering 5-star customer service in a hybrid work environment combining in-office and remote work.

• Team overview

  The specialist works closely with member relations and care teams but has no direct reports.

• Job location and travel

  The job is hybrid, involving both in-office and remote work.

• Unique job features

  This role is distinguished by its focus on being the subject matter expert for eligibility processes and its impact on member retention and transitions within AbsoluteCare programs.

Company overview

AbsoluteCare is a healthcare organization that provides comprehensive care management services, focusing on high-risk patients with complex medical needs. They make money through contracts with health plans and government programs, aiming to reduce hospital admissions and improve patient outcomes by offering integrated care solutions. Founded in 2000, AbsoluteCare has grown by emphasizing a holistic approach that includes primary care, behavioral health, and social services, making them a key player in value-based care models.

How to land this job

• Tailor your resume to emphasize your expertise in Medicaid and Medicare eligibility processes, highlighting your ability to manage complex enrollment and recertification tasks effectively.

• Showcase your experience working with health plan requirements and state eligibility criteria, demonstrating your role as a subject matter expert in enrollment and eligibility.

• Highlight your strong communication skills and your capability to provide 5-star customer service, as well as your proficiency in using Microsoft Office Suite and electronic medical record systems.

• Apply through AbsoluteCare’s corporate website and LinkedIn, and also explore other job boards that list this position to increase your chances of visibility.

• Connect with current AbsoluteCare employees in the enrollment or member relations divisions on LinkedIn; use ice breakers like commenting on recent company initiatives related to member retention or asking about best practices for managing eligibility changes.

• Optimize your resume for ATS by incorporating keywords from the job description such as 'Medicaid eligibility,' 'Medicare recertification,' 'member retention,' 'enrollment processes,' and 'state eligibility requirements' to ensure your resume passes automated screenings.

• Leverage Jennie Johnson's Power Apply feature to automate tailored applications across multiple platforms and identify LinkedIn connections for networking, freeing you to focus on preparing for interviews and other job search activities.