Case Management, Assistant

Mindlance; Texas; On-site; USD 45,000 - 65,000; Full time

Job summary

Mindlance is seeking a detail-oriented Eligibility and Enrollment Specialist to verify health coverage, document benefits, and coordinate information for Medicaid applications and related eligibility operations.

The role involves handling high-volume inbound/outbound calls, providing enrollment assistance for the HIPP/Premium Assistance program, accurate data entry, and timely processing to support revenue growth and program efficiency. A high school diploma is required.

Qualifications

• Minimum 2 years of experience in insurance industry, health care or government sponsored health insurance to include customer service and medical billing knowledge or similar math related experience.
• Minimum 2 year experience working on the phone making inquiries (outbound) and answering calls (inbound).
• Call Center Experience Preferred
• Human Resources or Health Insurance Experience preferred
• Bilingual Preferred
• Knowledge of health care terminology is a plus.

Responsibilities

• Provide enrollment assistance and HIPP/Premium Assistance program information over the phone to Medicaid eligible recipients and their family members.
• Verify, document, and investigate the presence of health care coverage for Medicaid recipients and their families.
• Assist in the identification of members that may qualify for the HIPP/Premium Assistance program.
• Complete periodic reports.
• Customer service to include high volume of phone work answering questions and other inquiries regarding the HIPP/Premium Assistance program.
• Data entry to include accurate and timely entry of information.
• Obtain and/or verify all items related to eligibility and enrollment into the HIPP/Premium Assistance program.
• Complete maintenance of active cases during open enrollment and premium review for check processing to assist with maintaining the revenue and program growth.

Skills

Customer service

Communication

Data entry

Microsoft Word

Excel

HIPAA knowledge

Teamwork

Education

High School Diploma or equivalent

Tools

Microsoft Word

Excel

Job description

Job Summary

We are seeking a talented individual who will be responsible for verifying, documenting, and coordinating information needed to process applications and other eligibility operations assignments. This individual will conduct health insurance policy analysis, documentation verification, employer coordination, and customer service while ensuring accurate data entry, validation, and timely processing.

Essential Responsibilities

• Provide enrollment assistance and HIPP/Premium Assistance program information over the phone to Medicaid eligible recipients and their family members.
• Verify, document, and investigate the presence of health care coverage for Medicaid recipients and their families.
• Assist in the identification of members that may qualify for the HIPP/Premium Assistance program.
• Complete periodic reports.
• Customer service to include high volume of phone work answering questions and other inquiries regarding the HIPP/Premium Assistance program.
• Data entry to include accurate and timely entry of information.
• Obtain and/or verify all items related to eligibility and enrollment into the HIPP/Premium Assistance program.
• Complete maintenance of active cases during open enrollment and premium review for check processing to assist with maintaining the revenue and program growth.

Other Responsibilities

Performs other functions as assigned

Knowledge, Skills and Abilities

• Ability to organize well.
• Strong Customer Service Skills
• Strong Communication Skills
• Ability to provide and represent professionalism in job.
• Ability to practice flexibility and adaptability in the work place.
• Ability to work with Microsoft Word and Excel and navigate internet skillfully.
• Ability to analyze information and use logic and process to address work-related issues and problems.
• Ability to operate with strong interpersonal skills.
• Ability to be careful and thorough about detail.
• Ability to perform data entry accurately.
• Average manual dexterity in use of a PC, phone, 10 key, sorting, filing and other office machines.
• Ability to handle conflict appropriately and constructively.
• Working knowledge of HIPAA privacy and Security rules.
• Ability to perform well in team environment.
• Ability to meet deadlines.
• Ability to handle pressure and deadline oriented project demands

Minimum Education

High School Diploma or equivalent required

Certifications (Required/Desired)

None

Minimum Related Work Experience

• Min. 2 year of experience in insurance industry, health care or government sponsored health insurance to include customer service and medical billing knowledge or similar math related experience.
• Min. 2 year experience working on the phone making inquiries (outbound) and answering calls (inbound).
• Call Center Experience Preferred
• Human Resources or Health Insurance Experience preferred
• Bilingual Preferred
• Knowledge of health care terminology is a plus.

Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

EEO

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”