Enrollment Specialist

NO PHONE CALLS PLEASE.


GENERAL DESCRIPTION:

The Enrollment Specialist will organize and input data that is needed to perform billing reimbursements. This employee must have the following knowledge/skills: Skilled in word-processing, data entry, and receptionist duties; able to make simple computations and tabulations accurately and with reasonable speed; able to deal with a variety of customers professionally and cheerfully, even under pressure; possess a general clerical aptitude and basic knowledge of record keeping; provide strong problem solving abilities; maintain confidentiality and discretion as a rule; able to understand and follow simple oral and written instructions and adhere to prescribed departmental routines; skilled in Microsoft Word and Excel and other advance computer office applications; excellent coordinating, consumer relations and organizational skills; strong contract auditing and monitoring skills; excellent telephone and customer service skills; strong documentation, filing, and recording skills; excellent oral and written communication skills; good quality assurance skills; strong planning and organizational skills; and basic knowledge of billing, insurance reimbursement and business practices related to the provision of mental health services in the state of North Carolina; cultural competence, energy and enthusiasm.

WORK DUTIES AND TASKS:

Administrative Duties: Essential Function, 90% of time

  • Verify insurance and correct discrepancies with client demographic information
  • Create and Update Authorizations
  • Enter Treatment Authorization Requests (TARs) for Mobile Crisis Management (MCM) service
  • Enter TARS for Outpatient Service
  • Make corrections to denied claims due to enrollment and or insurance issues
  • Verify the diagnosis and target pop
  • Attend staff meetings and administrative staff meetings and training/events as assigned.
  • Other duties as assigned.

Professional Activities: Essential Function, 10% of time

  • Attends a minimum of 2 hours of cultural competency continuing education per year.
  • Completes annual adult CPR and First Aid certification courses.
  • Completes annual TB tests and any other required competencies as outlined by the Human Resource Department for all staff.
  • Completes a performance evaluation in a complete and timely manner, annually.
  • Other duties as assigned

Collaboration with third party insurance providers: Essential Function, 8% of time

  • Develops and maintains open, effective, two-way communication with the Local management Entity and third party insurance companies
  • Other duties as assigned.

QUALIFICATIONS, EDUCATION AND EXPERIENCE REQUIREMENTS:

  • High school diploma or equivalent is required.
  • Experience (2 years minimum) in enrollments and/or billing
  • Ability to read, write, understand, and follow directions accurately and in a timely manner is required, position is extremely time-sensitive
  • Strong computer skills
  • Ability to multi-task
  • Must possess a valid driver's license and be proficient in spoken and written English.
  • No criminal convictions of child abuse or violent crimes.
  • Proven ability to maintain strict confidentiality.

In addition to competitive salaries and opportunities for advancement, full-time employees are offered a wide range of benefits to meet their individual needs, which includes:

Medical, Vision, Dental Insurance.

Life Insurance (Paid by Company).

PTO (Paid Time Off).

Paid Holidays.

Longevity Pay.

401K Retirement Plan.

Funeral Leave.

FMLA.

Supplemental Insurance offering through Aflac with Payroll Deduction.

Direct Deposit.

Training Opportunities.

Continuing Education Leave for Licensed Professionals (opportunity to gain free CEU's).

Free Clinical Supervision in Greenville (LCSWA/LCASA/CSAC)