Enrollment Specialist, ADAP

Latham NY 12110 15 Cornell Rd

Job Description

This position is responsible for processing, data entry and file maintenance of enrollment, assessment and dis-enrollment documentation for strategic business unit (SBU) operations.
  • Effectively supports Magellan's SBU program operations ensuring that data is entered accurately and timely as required by contract service level agreements.  
  • Communicates with appropriate contacts on eligibility issues and questions.  
  • Answers incoming calls on eligibility, program benefits, plan limitations and point of sale edits from providers.  
  • Proficient use of enrollment and claims point of sale for research and problem resolution.
  • Assists in data collection and reporting.  
  • Completes bi-weekly checkwrite production for provider payment in the accounts payable system, reporting all operational issues and assisting with system issues.
  • Assists with quality monitoring and provides constructive feedback.
  • Reviews production reports, identifies issues and recommends resolutions.
  • Continually seeks to improve processes and increase efficiencies.
  • Assists in data collection and reporting.
  • Other special projects as required by management.

General Job Information

Title

Enrollment Specialist, ADAP

Grade

17

Job Family

Customer Service Group

Country

United States of America

FLSA Status

United States of America (Non-Exempt)

Recruiting Start Date

12/13/2019

Date Requisition Created

12/13/2019

Work Experience

Managed Healthcare, Medicaid, Medicare

Education

Bachelors

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

  • 2+ years of experience in a Medicare/Medicaid managed care environment.
  • Working knowledge of Medicare and Medicaid enrollment and reconciliation requirements, CMS reporting, and data analysis.
  • Solid understanding of the Medicare and Medicaid payment methodology.
  • Strong verbal and written communication skills.
  • Organized with strong attention to detail.
  • Ability to meet deadlines.
  • Strong working knowledge of Microsoft Office Product Suite.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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