Enrollment Specialist Resume Examples

enrollment specialist

  • Received inbound & Outbound calls and directed them to the appropriate departments.
  • Assisted prospective and current members with choosing Medicare health plans.
  • Reviewed plan information with the current and prospective members.
  • Maintained communication with member services departments and supervisors.
  • Assisted with health assessments and entered new customer’s profiles into the database. 

enrollment specialist

  • Assist customers in understanding their options, enrolling in health plans, and determining eligibility for Subsidies and tax credits
  • Using Meds software and IQS software determine which managed care program the beneficiary can choose from. 
  •  Handles telephone communication and written correspondence with providers, and fiscal intermediaries in an efficient and effective manner that facilitates the Provider Enrollment process.
  • Correct applications to verify enrollment, Make adjustments to Insurance plans, Assist with Manged care, Physicians or Dentist.
  • Communicate with third party insurance agencies to manage Enrollment, Specialize in Polices, Adhere to a Call Queue, Assist with locating Primary care physicians, Hospitals, and or Behavioral  

enrollment specialist

  • Over sees their preparation, processing and maintenance of new members and re-enrollees.
  • Assigning PCP’s to qualifying members. 
  • Enter, update, and review data to ensure correct data are available by utilizing the State’s Rosters. 
  • Understand, explain, and document Medicare and Medicaid needs to employees and members.
  • Seek information where gaps of coverage are identified.

enrollment specialist

  • Lead a group of “New Hires” for training purposes.
  • Correspond with Tier manager to ensure call flow.
  • Gather clients information via telephone over a recorded line.
  • Enroll clients into HMO, PPO, and Medicare Advantage health plans.
  • 2nd place in Top 3 Enrollment Specialist out of a group of 25

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