Enrollment Specialist

Employment Type

: Full-Time

Industry

: Miscellaneous



Job Description About Conduent

Conduent delivers mission-critical ​services and solutions on behalf of businesses and governments – creating exceptional outcomes for its clients and the millions of people who count on them. Through people, process and technology, Conduent solutions and services automate workflows, improve efficiencies, reduce costs and enable revenue growth. It’s why most Fortune companies and over government entities depend on Conduent every day to manage their essential interactions and move their operations forward.

Conduent’s differentiated services and solutions improve experiences for millions of people every day, including two-thirds of allinsured patientsin the U.S., million employees who use its HR Services, and nearly nine million people who travel through toll systems daily. Conduent’s solutions deliver exceptional outcomes for its clients including $ billion in medical bill savings, up to % efficiency increase in HR operations, and up to % improvement in processing costs, while driving higher end-user satisfaction. Learn more atwww.conduent.com.


Job Description

The Enrollment Specialist is responsible for screening, tracking, reporting and completing Wyoming Medicaid enrollment applications submitted (electronically or paper) by new or re-enrolling providers. Providers may be physicians, nurse practitioners, mental health providers, dentists, medical suppliers, hospitals, nursing facilities, to mention a few. In addition to enrollments this position is responsible for ensuring provider's submitting updates to their records are screened, reported and completed as appropriate. The Enrollment Specialist plays a major role when enrollment and provider files are audited by third parties. This position is responsible for following and maintaining the Enrollment and Update Operational Procedures.

MAJOR POSITION RESPONSIBILITIES:

  • Screen, track, report, process and complete incoming Medicaid provider enrollments
  • Screen, track, report, process and complete incoming Electronic Data Interchange (EDI) enrollments from providers, clearinghouses and vendor software companies
  • Returns incomplete enrollment applications as appropriate
  • Coordinates the distribution of provider Welcome Letters and policy manuals
  • Screen, track, report, process and complete incoming provider file updates
  • Returns incomplete provider updates as appropriate
  • Ensures proper provider file maintenance
  • Follow and maintain the Enrollment and Update Operational Procedures
  • Prepare and respond to audit requests and inquiries
  • Communicates directly with call center agents, all internal departments, providers, potential providers, clearinghouses, software vendors, auditors, supervisors, managers, Office of Medicaid and State Agencies.
  • Conducts enrollment and update training
  • Researches and follows through on several rejection reports to ensure providers receive payment
  • Staffs Department Help Desk to field questions from the Provider Relations Call Center phone agents
  • Meet quality controls and production standards of the Provider Relations Department
  • Other duties as assigned
  • QUALIFICATIONS:

  • Previous call center experience
  • Three years customer service experience and excellent customer service skills
  • Excel, Access and Word software experience
  • Selected individual will have the following attributes

  • Strong organizational and communication (verbal and written) skills
  • Ability to meet or exceed deadlines
  • Ability to prioritize multiple tasks
  • Strong analytical, comprehension, and problem solving skills
  • Ability to follow verbal and written instructions
  • Personal computer experience
  • Must be detail oriented
  • Strong time management skills
  • Must be able to work independently and as a team member
  • Ability to handle stressful situations
  • Proficient keyboarding skills
  • Excellent attendance record
  • Ability to maintain confidentiality
  • SENSITIVITY OF POSITION:

  • Access to Protected Health Information (PHI)
  • Access to Individually Identifiable Health Information (IIHI)
  • Access to confidential Medicaid information


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