Enrollment and Benefits Specialist

CF Solutions Philippines Inc.; Quezon City; On-site; PHP 268,000 - 402,000; Full time

Job summary

CF Solutions Philippines Inc. seeks a Care Coordinator to verify CCM eligibility, review records, and coordinate enrollment for patients in Metro Manila.

You will educate patients on the app, guide registration steps, document outcomes in the Productivity Tracker, and ensure HIPAA-compliant communications.

Strong communication, attention to detail, and multi-system documentation are essential.

Qualifications

• Experience in healthcare customer service, patient outreach, care coordination, or related roles preferred.
• Knowledge of HIPAA regulations and patient privacy requirements.
• Strong verbal communication and patient engagement skills.
• Excellent organizational skills and attention to detail.
• Ability to navigate multiple systems and accurately document patient interactions.
• Proficient computer and data entry skills.

Responsibilities

• Verify patient eligibility and CCM benefit eligibility across EMR and insurance portals.
• Notify staff when coverage is inactive and coordinate status updates in CCM platform.
• Conduct outbound/inbound calls to explain CCM program benefits and enrollment requirements.
• Perform HIPAA-compliant patient verification before discussing PHI.
• Explain program benefits, responsibilities, consent, and participation expectations.
• Guide enrollment steps: birth date, consent, terms, credentials, and health questionnaires.
• Educate patients on app usage and messaging with Care Team.
• Verify consent status updates, assign Care Coordinator, and document in required systems.
• Update patient enrollment status and call outcomes in Productivity Tracker.
• Ensure all notes and interactions comply with standards and regulatory requirements.

Skills

Healthcare support

Patient outreach

Care coordination

Medical administration

HIPAA compliance

Verbal communication

Patient engagement

Organization

Documentation

Data entry

Job description

Key Responsibilities:

Patient Eligibility Verification

• Review patient records within the electronic medical record (EMR) system to identify CCM-eligible patients based on qualifying diagnosis codes.
• Verify active insurance coverage and determine CCM benefit eligibility through designated insurance portals.
• Document eligibility and benefits verification findings accurately in the Productivity Tracker.
• Notify designated personnel when patient insurance coverage is inactive and coordinate required status updates in the CCM platform.

Patient Outreach and Enrollment

• Conduct outbound and inbound patient calls to introduce and explain the benefits of the Chronic Care Management program.
• Perform HIPAA-compliant patient verification before discussing protected health information.
• Clearly communicate program benefits, patient responsibilities, consent requirements, and participation expectations.
• Utilize active listening skills to address patient concerns and effectively position the value of the CCM program.
• Handle enrollment objections professionally and document patient decisions appropriately.

Application Setup and Patient Education

• Send enrollment application links to eligible patients.
• Guide patients through the application registration process, including:
  • Entering date of birth
  • Reviewing and accepting consent forms
  • Accepting terms of use
  • Creating username and password credentials
  • Completing required health questionnaires
• Educate patients on proper use of the application, including the messaging feature for communication with the Care Team.

Documentation and System Management

• Verify consent status updates within the CCM platform and confirm assignment to the appropriate Care Coordinator.
• Maintain accurate and timely documentation in CCIQ and all required systems.
• Update patient enrollment status and call outcomes within the Productivity Tracker.
• Ensure all records, notes, and patient interactions are documented according to company standards and regulatory requirements.

Systems and Tools

• (EMR System)
• CCIQ
• Productivity Portal/Tracker
• Insurance Verification Portals

Required Qualifications

• Experience in healthcare customer service, patient outreach, care coordination, medical administration, or related healthcare roles preferred.
• Knowledge of HIPAA regulations and patient privacy requirements.
• Strong verbal communication and patient engagement skills.
• Excellent organizational skills and attention to detail.
• Ability to navigate multiple systems and accurately document patient interactions.
• Proficient computer and data entry skills.