Job Description

STAR OF CA, A STEPPING STONES GROUP COMPANY, IS CURRENTLY INTERVIEWING ENROLLMENT SPECIALISTS LIKE YOU IN VENTURA, CA!

THIS IS FULL TIME, M-F WITH FULL BENEFITS. 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Receives Eligibility & Consent Form from intake
• Sends correspondence and updates to clients regarding their benefits and the steps taken to seek authorization, per client health plan guidelines
• Updates client basic contact info in Central Reach
• Creates, distributes, and audits receipt of Client Enrollment Packets sent to family
• Reviews client diagnostic reports and treatment plans to ensure they meet health plan specific criterion; make recommendations on how to proceed if further evaluation is required
• Prepares authorization requests for health insurance companies
• Tracks authorization status
• Receives feedback from health insurance company care managers and works with clinical team to take any corrective measures needed to secure client authorization
• Reviews authorizations for accuracy
• Tasks authorizations to be entered into Central Reach
• Uploads client documents in Central Reach
• Verifies authorization after it has been entered
• Updates meta data and pertaining client labels in Central Reach
• Creates, distributes, and audits receipt of cost projections for all cases needed
• Corresponds with Billing Team regarding benefit detail discrepancies and works to propose workable solution
• Corresponds with families regarding their funding’s coverage and eligibility
• Provides administrative back-up when necessary (answer phones, scanning, filing, etc.)

QUALIFICATIONS:

• High School Diploma required
• Insurance experience required
• Previous enrollment experience preferred
• Familiarity with Catalyst, Relias, CentralReach and similar platforms preferred
• Previous experience with Microsoft Office suite preferred
• Bilingual/Spanish speaking preferred
• Excellent customer service skills
• Ability to multitask and work under intensive deadlines
• Excellent verbal communication and written communication skills
• Ability to maintain a high level of confidentiality for patient protected health information in accordance with legal requirements and company policy

INTERESTED CANDIDATES PLEASE REPLY WITH A RESUME AND CONTACT INFO.

Thank you!