Enrollment Specialist

Mosaic Community Health; Bend (OR); On-site; USD 42,000 - 56,000; Full time

Job summary

Mosaic Community Health in Central Oregon seeks an Enrollment Specialist to guide patients through insurance applications and eligibility for Medicaid, Oregon Health Plan, and other programs. You will verify information, assist with re-enrollment, and document steps in the EMR, ensuring accurate patient data and timely follow-up.

You will perform outreach with community partners, conduct pre-registration and registration pre-verification, and help patients understand sliding scale eligibility.

Qualifications

• Experience assisting patients with insurance applications.
• Knowledge of Medicaid/Medicare eligibility and enrollment.
• Strong oral and written communication with diverse populations.

Responsibilities

• Assist patients with state and federal insurance applications and eligibility.
• Coordinate outreach and enrollment assistance with community partners.
• Document enrollment status in EMR per procedures.
• Travel region to support enrollment activities.

Skills

Bilingual Spanish/English

Health insurance knowledge

Communication skills

Tools

EMR system

Job description

Description

The Enrollment Specialist is the primary point of contact for Mosaic patients with insurance applications and eligibility requirements with state and/or federal insurance programs, including Oregon Health Plan. This includes contacting patients for re-enrollment and assisting the Billing Department with insurance verifications. The Enrollment Specialists will conduct Outreach activities with community partners and other organizations to provide information and enrollment assistance. This position will develop and maintain statistical enrollment reports and manage reports provided by the organization for enrollment and re-enrollment. This position will travel throughout the region to support enrollment assistance. Additionally, this role will be handling pre-registration and registration pre verification for all patients at Mosaic, new or established. Entering, auditing, educating, and advocating for accurate registration in the patient’s electronic medical record (EHR). This role identifies patients who have termed from Medicaid/Medicare. When termed, reaches out to patients to inquire as to why they termed and assists patients in navigating the Enrollment process. Provides education on Medicaid eligibility and sliding scale eligibility. Bi-lingual in Spanish/English strongly preferred.

• Aid and process state and/or federal applications for insurance coverage for patients and community members.
• Troubleshoot application questions or concerns from patients and community members.
• Serves as a liaison between state/federal systems and patient, providing timely follow-up and processing of applications and insurance eligibility status.
• Timely documentation of all assistance including insurance eligibility status in the electronic medical record (EMR) per procedure.
• Monitor enrollment reports to identify enrollment assistance needs.
• Active patient outreach to capture patient eligibility status at patient visit.
• Community outreach to educate and assist community members with enrollment needs.

Job Details

The Enrollment Specialist is the primary point of contact for Mosaic patients with insurance applications and eligibility requirements with state and/or federal insurance programs, including Oregon Health Plan. This includes contacting patients for re-enrollment and assisting the Billing Department with insurance verifications. The Enrollment Specialists will conduct Outreach activities with community partners and other organizations to provide information and enrollment assistance. This position will develop and maintain statistical enrollment reports and manage reports provided by the organization for enrollment and re-enrollment. This position will travel throughout the region to support enrollment assistance. Additionally, this role will be handling pre-registration and registration pre verification for all patients at Mosaic, new or established. Entering, auditing, educating, and advocating for accurate registration in the patient’s electronic medical record (EHR). This role identifies patients who have termed from Medicaid/Medicare. When termed, reaches out to patients to inquire as to why they termed and assists patients in navigating the Enrollment process. Provides education on Medicaid eligibility and sliding scale eligibility. Bi-lingual in Spanish/English strongly preferred.

Patient Enrollment

• Aid and process state and/or federal applications for insurance coverage for patients and community members.
• Troubleshoot application questions or concerns from patients and community members.
• Serves as a liaison between state/federal systems and patient, providing timely follow-up and processing of applications and insurance eligibility status.
• Timely documentation of all assistance including insurance eligibility status in the electronic medical record (EMR) per procedure.

Outreach

• Monitor enrollment reports to identify enrollment assistance needs.
• Active patient outreach to capture patient eligibility status at patient visit.
• Community outreach to educate and assist community members with enrollment needs.

Customer and Access Services

• Advise patients of their Enrollment status with Medicaid/Medicare and aid as needed
• Advise patients of financial and/or insurance documentation required for appointments as well as educate patients on different payment options offered

Scheduling

• Schedule patients in Enrollment appointments as needed
• Provide system or clinic support for New Patient and Enrollment scheduling, rescheduling, and cancellations
• Confirm patient demographics, registration, and insurance information and update EHR as needed
• Promote and educate, MyChart use

Pre-Registration

• Create new patient records in EHR
• Patient activation and education on use and benefits of MyChart
• Complete the patient registration process and document in the EHR
• Educate patients on FPL, Medicaid, and Marketplace requirements as well as assisting with over the phone support when possible

Registration Pre-Verification

• Auditor of patient charts to ensure accurate financial registration
• Updates patients charts to ensure accurate financial registration including coverage’s, guarantors, demographics, annual incomes, and any other registration field that needs correcting
• Reaches out to patients to get updated corrected information for accurate financial registration
• Works with billing and site supervisors to coordinate needed paperwork and forms for patients
• Working in basket messages relating to registration updates, Medicaid eligibility, and sliding scale eligibility

Skills & Knowledge

Working knowledge of health insurance plans including Medicaid and Medicare. Excellent oral and written communication skills, including effective communication with patients on complex or technical information regarding insurance coverage. Ability to develop and present effective presentations in different location settings and group size. Ability to prepare basic correspondence and simple reports in Microsoft Word and Excel. Ability to create, send and manage email in Outlook. Ability to access and use web-based applications and EMR program. Understanding of healthcare navigation including insurance types, concepts, terminology, billing, and/or regulations required. Knowledge of standard office policies and procedures. Knowledge of Microsoft Office software products preferred. Computer literacy and typing skills. Training in Marketplace enrollment preferred. Knowledge of standard office machines including copier, fax, shredder, multi-line telephone, printers, etc. Excellent customer service skills and ability to effectively and respectfully handle dissatisfied patients. Bi-lingual in Spanish/English strongly preferred.

Who We Are

Mosaic Community Health prides itself on being an innovative health system that pioneers unique and creative ways to provide and improve patient access to health care. Since our founding in 2002 we have proudly served insured and uninsured patients regardless of age, ethnicity, or income. We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way. At Mosaic Community Health, you will work with incredibly dedicated and mission-centered peers and be part of a dynamic team based environment. Mosaic Community Health offers more than just a job, it is a lifestyle. A lifestyle of serving others. A lifestyle of being an integral part of your community. A lifestyle that offers work/life balance. A lifestyle of enjoying the outdoors! Central Oregon offers over 300 days of sunshine a year, so enjoy a PTO day on the mountain, biking/hiking trails, or the river! A lifestyle that improves lives, including yours. Of course, we also offer a great benefit package!