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Candidate Info
16
years in workforce
10
months at this job
AS
Associate of Science
BS
Health Care Administration And Management
Medical Insurance Billing And Coding
Provider Enrollment Specialist
Processed, verified, and validated Texas Medicaid applications for all providers across the State of Texas
- Operated with an extreme level of accuracy while consistently maintaining a 98% quality score of all completed applications
- Analyzed all required documentation from providers for successful enrollment into the Medicaid programs: Traditional Medicaid, Texas Health Steps Medical and Dental, and the Children with Special Healthcare Needs Services Program
- Identified mistakes, omitted information, and missing forms and attachments and relayed the information to the provider and/or the provider's representative to ensure timely completion
- Conducted preliminary background checks to be verified against any exclusion lists for non-participation into Federal and State programs prior to enrollment
Candidate Info
11
years in workforce
7
months at this job
Provider Enrollment Specialist
Responsible for enrolling and credentialing Providers into Texas Medicaid
- Established relationships with Providers offices to ensure proper handling of documentation
- Provided follow through with Office Staff to ensure fast and proper handling/processing application
- Trained and Monitored new staff for quality and professionalism
Candidate Info
8
years in workforce
5
months at this job
AAS
Microcomputer Systems Technology
BA
English
Graphic Design
Provider Enrollment Specialist
- Organized provider files and performed desk reviews of Medicare applications in accordance with standard operating procedures to ensure all documentation is enclosed to meet Medicare laws and regulations for providers to receive Medicare reimbursement
- Monitored the timeliness of each application type to ensure objectives are met in accordance to the Centers for Medicare and Medicaid Services guidelines
- Reviewed and validated each application in its entirety for accuracy and completeness for Medicare auditing
- Utilized various Medicare systems and databases, in addition to the Internet, to research and validate information and enter into various Medicare enrollment databases
- Communicated with providers throughout the Medicare enrollment process
- Reported any anomalies associated with compliance in applications that would not be acceptable based on Medicare laws and regulation
Candidate Info
18
years in workforce
5
months at this job
Enrollment Specialist/ Data Entry
- Assisted with reporting monitoring and general quality assurance.
- Oversaw member information reconciliation procedures and paperwork.
- Researched and resolved discrepancies in enrollment activities.
- Handled and evaluated customer inquiries and complaints.
- Ensured integrity of enrollment eligibility processes.
Candidate Info
15
years in workforce
2
years at this job
Travel And Tourism
Business
Enrollment Specialist
- Assist clients with the on-line submission of SNAP and Medicaid applications.
- Provide case management to reach desired outcome for client.
- Increase productivity by creating fun team environment that brings the feel of unity and empowerment.
- Follows up with clients in an efficient and timely manner.
- Coordinated and launched the texting Platform for [company name] info line from inception 8% of reply rate of text to 38% reply rate in 3 months and growing.
- Created waitlist that helped assist clients in need of immediate assistance.
Candidate Info
10
years in workforce
4
months at this job
MS
Geography And Regional Planning
Enrollment Specialist
- Recruited, enrolled, and helped 6 individuals start classes within my first two weeks
- Represents [company name] at career fairs to recruit students
- Initiated the development for obtaining documents for students' acceptance
Candidate Info
18
years in workforce
2
years at this job
HS
High School Diploma
Business
Enrollment Specialist
Responsibilities are to recruit and interview potential students and to convert those first contacts into future starts by introducing programs to potential students.
- 25% of my future starts come from PDR’s
- Maintained a 90-100% show rate since 2012
- Consistently achieve start goals
Candidate Info
9
years in workforce
1
year at this job
HS
High School Diploma
Sales and Enrollment Specialist, Corporate Call Center
- Completed online medicare supplement applications for enrollees.
- Provided detailed explanation of coverage benefits and provisions.
- Ensured accurate documentation and plan selection.
- Obtained Health license April 2014.
Candidate Info
16
years in workforce
6
years at this job
HS
Additional
Enrollment Specialist/process Auditor/administrative Assistant
- Assisted with processing off exchange applications for new enrollees and conversion applications via SharePoint and CEAC.
- Tracked and sent all consumer payments to billing and enrollment to be accurately reflected on customer accounts on- exchange and off- change.
- Abided by HIPAA requirements and standards by ensuring and protecting consumers' confidential, identifiable, and professional information to third parties.
- Supervised and audited consumer applications for accuracy in order to expedite to the outsourcing team for processing.
- Maintained expertise in eligibility, enrollment and program specifications of the Federal Marketplace and other individual healthcare plans in order to assist consumers in selecting the most viable coverage.
Candidate Info
8
years in workforce
1
year at this job
HS
High School Diploma
Liberal Studies
Enrollment Specialist
- Assisted with the preparation of collateral materials for several student orientations, information meetings, and job fairs as needed.
- Competently conducted the activities necessary for proper recruitment of undergraduate and graduate students, following established guidelines and standards.
- Conducted student appointments to disseminate course and program information to new or potential students.
- Assisted in the compilation and preparation of student admission files prior to submission to the partner university’s academic advisement department.
Candidate Info
5
years in workforce
2
years at this job
Makeup Artistry
Enrollment Specialist
- Processing of and preparation of new member enrollments.
- Completed dis-enrollments as needed.
- Verified and corrected member eligibility issues at least monthly.
- Communicated with members and doctors regarding benefits.
- Utilized state enrollment systems and managed care enrollment systems.
- Conducted all work in accordance with the confidentiality requirements mandated by HIPAA for member information.
Candidate Info
9
years in workforce
10
months at this job
Medical Office Specialist
Remote Member Liaison / Enrollment Specialist - Telecommute
- Creation of daily task communications between other departments for the routing of information needed to provide adequate details pertaining to enrollment questions, invoicing and possible claims/appeals generated by the member.
- Researched and investigated systems for incorrect dates of enrollment spans, missing payments, and member disputes concerning billing.
- Reconcile all member eligibility, enrollment, and disenrollment data accurately between CMS and the insurance company.
- Updated member's enrollment records according to Policies and Procedures in an effort to correctly determine the correct processing of reinstatements, retro terminations and cancellations of the member's plan coverage.
Candidate Info
10
years in workforce
10
months at this job
BA
Journalism And Mass Communication
Enrollment Specialist
- Enthusiastically enroll advance practice nurses (BSN & MSN) in Wilkes University's online program
- Spearheaded POWER HOUR meeting to help improve student retention and persistence
- Drafted new forms to streamline the enrollment and registration process and increase efficiency
- Administered a training on setting deadline and following up to collect collateral
- Implemented motivating games to drive prospecting activity
- Provided leadership with process improvement recommendations to improve efficiency and effectiveness
- Drafted emails to increase written communication options for Enrollment Specialists to use
Candidate Info
20
years in workforce
2
years at this job
BA
Business Administration
MA
Management
Enrollment Specialist
Contact potential students via phone and/or email to build rapport and assist with the initial application process
- Help students chose the right programs based on their needs and the degree programs available
- Schedule follow-up calls and maintain high level of customer service
- Walk students through documents and enroll into their courses
- Submit and track computer issues for the enrollment specialist team
Candidate Info
8
years in workforce
2
years at this job
Enrollment Specialist
- Documented all customer inquiries and comments thoroughly and quickly.
- Responded to all customer inquiries thoroughly and professionally.
- Referred unresolved customer grievances to designated departments for further investigation.
- Reinvented how team interacts with prospective clients by developing innovative and creative sales pitch that was implemented into sales team strategy.
- Consistently hit and exceeded sales goals.
- Defused volatile customer situations calmly and courteously.
- Effectively managed a high-volume of inbound and outbound customer calls.
Candidate Info
13
years in workforce
2
years at this job
BBA
Business Marketing
Enrollment Specialist
As an Enrollment Specialist I perform variety of duties with the ultimate goal of enrolling children with [company name].
- Answer phones in a timely manner; providing information on school requested by parents.
- Schedule tours with families looking for child care
- Complete call logs and reports accurately and honestly daily and weekly
- Manages data in the inquiry system.
- Share information with other enrollment specialist as necessary for the benefit of the enrollment office in a co-operative
Candidate Info
4
years in workforce
5
months at this job
BA
Graphic Design
Enrollment Specialist
- Analyzed and organized submitted documents from small businesses.
- Drafted and emailed agent/group admit for missing tax documentation.
- Accurately input groups’ information to generate firm quote for Underwriting submission.
Candidate Info
8
years in workforce
10
months at this job
HS
Medical Billing And Coding
HS
High School Diploma
Pharmacy Technician
Medicaid/ Medicare Enrollment Specialist
- Intake, data entry, and registration of new patient demographics, insurance, financial eligibility, and prescriptions into system.
- Processed Medicaid and Medicare insurance eligibility verification, prior authorizations, medication and procedure appeals, pre-certifications, enrollment requests, disenrollment request, tracking and monitoring of enrollment materials, reviewing and updating member records.
- Communicated with Doctors, members and insurance companies on a daily basis regarding members accounts.
- Analyzed and resolved member escalated eligibility issues, issued ID cards, member reading materials, extraction of PCP term letters, retraction of incorrect letter.
- Processed Provider Relations requests for PCP mass moves and individual PCP changes requests.
- Daily, monthly, annual reconciliation of Medicare 834 transaction files (TRR, MMA, Auto Enrollments, etc) to ensure end to end processing and SLA’s were met.
- Reconciliation of various states transactional reports. Corrected errors and resubmit transactions to state markets. Researched and resolves financial membership and payment discrepancies.
Candidate Info
24
years in workforce
8
months at this job
BS
Graphic Design
Enrollment Specialist
- Conducted inbound and outbound calls to register prospects for company endorsed seminars/personal consultations.
- Handled inbound calls from Medicare recipients requesting literature on Medicare Advantage Plans.
- Educated prospects on healthcare and the benefits of Medicare Advantage Plans.
- Processed Medicare Advantage enrollment requests in compliance with state and federal regulations.
Candidate Info
14
years in workforce
5
months at this job
Enrollment Specialist
- Answered incoming phone calls from employees.
- Answer questions concerning employees medical benefits for 2016 and Open Enrollment 2017
- Enroll employees and their dependents
- Make changes to enrollments once employees received confirmation letters and information needed to be corrected
Candidate Info
13
years in workforce
8
years at this job
AAS
Radiography
Enrollment Specialist
At Home Business
- Exceed customer fulfillment survey goals through impeccable communication skills
- Precise efficiency with multi-tasking several software programs simultaneously
- Assist clients with enrollment of various electrical services
- Provide outstanding knowledge and support to surpass client expectations
Candidate Info
8
years in workforce
2
years at this job
AS
Science
Enrollment Specialist
Handled outbound & inbound calls for external & internal customers.
- Properly direct calls in & out of phone queues to improve call flow
- Worked with management to ensure appropriate changes were made to improve customer retention
- Conducted training sessions with staff to practice & ensure quality customer satisfaction.
- Heightened any interest in company products & service through building rapport with each customer.
Candidate Info
10
years in workforce
2
years at this job
C
Paralegal Studies
BS
Mass Communications Arts
Account Manager- Enrollment Specialist- Client Services
- Exceeded targeted quota by 45 days
- Increased referrals from Support Coordinators, Referral Agencies and Clients 60%
- Review Enrollment Contracts to insure compliance
- Coordinate implementation of new customers
- Resolve issues for existing client base
- Payroll and Medicare Claim support
Candidate Info
2
years in workforce
4
months at this job
HS
High School Diploma
Enrollment Specialist
I'm experienced in Microsoft word, Excel and PowerPoint. I work in Excel everyday for my daily work. I bring members up in different systems within Humana an find problems with their enrollment.
- Here's just a few things I do on a daily basis at Humana.
- Enter, update, and review data to ensure correct data are available.
- Understand, explain, and document Medicare and Medicaid needs.
- Analyze data to identify trends, opportunities, and potential knowledge gaps.
- Seek information where gaps are identified.
Candidate Info
4
years in workforce
3
months at this job
BA
Communication
Enrollment Specialist
- Ensured enrollment went smoothly through fact checking.
- Confirmed effective enrollment via both phone and email.
- Involved in Terminations, Enrollments and specific insurance policy qualifications.
- Daily use of Microsoft Office, Excel and Outlook.
Candidate Info
9
years in workforce
6
months at this job
BBA
Economics
Enrollment Specialist
- Provide information and education about the Affordable Care Act to community members
- Facilitate enrollment in health insurance, CHIP, Medicaid and MAP
- Maintain knowledge and expertise in eligibility, enrollment, and program specifications of the Health Insurance Marketplace, and premium assistance programs
- Case management
- Assist with intake and screening of up to 150 community members in a day
- Protect confidential consumer information
Candidate Info
11
years in workforce
3
years at this job
Information Technology
Computer Science
Patient Enrollment Specialist - Tier II
- Handles 150+ outbound and inbound calls per day via Shortel & Presence; providing overview of the program and responding to questions about the program enrollment, encourages immediate assessment of enrolled participants
- Able to meet established performance metrics that include: Quality, Sales, Enrollments and Operational
- Utilizes multi-media resources to accurately process participant information; obtaining all demographic
- Develops rapport with participants and adjusts to their communication style.
- Provides accurate and compelling information about Alere's programs and services.
Candidate Info
18
years in workforce
11
years at this job
MA
Somatic Coach
Enrollment Specialist
Managing all aspects of student enrollment/sales for a professional training organization offering courses in executive leadership, somatic coaching, and self-development.
- Partner with organizational leadership to set marketing and sales budget
- Develop detailed marketing strategy based on strategic goals
- Provide routine presentations and reports on sales and marketing to organizational leadership
- Build long-term sales relationships with prospects and students
- Manage internal customer tracking system (File Maker Pro)
- Leverage social media marketing (Facebook, YouTube, blog, recordings, etc.)
- Design advertising, communication strategy, promotional outreach and conferences presence
Candidate Info
3
years in workforce
9
months at this job
AS
Associate of Science
Medical Assisting
Impact Provider Enrollment Specialist
- Responsible for assisting all callers in the medical professions and therapy fields with getting enrolled in the State of Illinois' new enrollment system called IMPACT
- Answered any and all questions pertaining to the IMACT system involving invoices, payments, coverages, etc.
- Troubleshooting with clients who were stuck during the enrollment process including software and/or CPU issues.
- Trained State Of Illinois workers on IMPACT software
- Contractual State assignment
Candidate Info
23
years in workforce
1
year at this job
BA
History
Special Education
Enrollment Specialist
- Recruits students to the college and conducts admissions counseling
- Organizes committee meetings with administration, faculty, and staff to plan and implement events and initiatives
- Developed, maintains, and mails two RVCC publications: The Alumni Advocate and Transitions: RVCC's Newsletter for Educators
- Plans and/or assists in planning and organizing college outreach events on and off campus including: Lebanon Academic Center grand opening celebration, campus visits, discovery day events for high school students, information sessions, open houses, and conventions
- Maintains and updates the college's Facebook and Twitter accounts
- Designs marketing materials with InDesign software and assists the Marketing Department with special projects as needed
Candidate Info
7
years in workforce
6
months at this job
HS
High School Diploma
Enrollment Specialist
- Aided processing member enrollment eligibility.
- Evaluated and handled customer inquiries.
- Managed outbound verification calls to members.
- Assured enrollment eligibility is processed
Candidate Info
7
years in workforce
8
months at this job
AS
Applied Science
BS
Health Care Systems Administration
Enrollment Specialist
- Support the Enrollment teams mission under Revenue Cycle Department in processing Open Enrollment, new group, and renewals for Commercial insurance via Agent and Employer requests and submissions
- Maintain monthly reports for Open Enrollment, New Group, Max Age, PCP Transfers/Discharges, etc that allow for seamless flow of group employer coverage
- Interact with interdepartmental personnel, Agents and Employer Human Resource representatives to allow for up-to-date and immediate updates to coverage
- Maintain updates for EyeMed vendor and interact with vendor for verifications
Candidate Info
35
years in workforce
28
years at this job
Enrollment Specialist and Team Leader
- Responsible for greeting and completing on-site registration of patients
- Prioritize registration based on clinic schedules and patients appointments
- Assisted high risk patients with enrollment in State funding programs and medical care
- Evaluated patients medical needs and financial eligibility
- Lead 14 staff employees and conducted performance evaluations
- Provided assistance in the preparation of Private Executive Luncheons and Dinner parties.
- Processed payroll in Kronos.
Candidate Info
5
years in workforce
1
year at this job
HS
High School Diploma
Pharmacy Technician
Benefit Enrollment Specialist
Serve as the first response for benefit, Cobra, Retirees, and LOA questions for employees.
- Administers benefits on-boarding process for new hires
- Audit benefit enrollment, and change submissions to ensure accuracy
- Assist with implementation and maintenance of all benefit plans within the department
- Assist with benefit open enrollment, educate, and communication to the company
- Assist with administration of the Wellness Program
- Assume additional duties as assigned responding to departmental needs on the ongoing team
Candidate Info
5
years in workforce
3
years at this job
AAS
Business
BA
Upstate
Senior Enrollment Specialist
- Schedule and conduct tours of the campus, providing general information on campus services and policies
- Contacts candidates assigned to them using the phone, email and other approved methods
- Introduce candidates to other departments and their services and helps coordinate between department to answer student questions or resolve issues
- Build lead flow through referrals from new and existing students
- Create sense of urgency and commitment for longevity of students educational completion and success
- Create plan to execute daily, weekly and monthly enrollment goals
Candidate Info
26
years in workforce
4
years at this job
BS
Finance
MA
Health Care Management
Enrollment Specialist
- Contact assigned candidates via phone, email and other approved methods
- Assesses candidate qualifications, understands goals and suitability for career field
- Covers all disclosures and compliance information with students
- Maintains contact with students throughout enrollment process and into students' second term
- Accurately records all activity and information relevant to student enrollment.
Candidate Info
7
years in workforce
3
years at this job
Information Management
Enrollment Specialist
- Collect and analyze data on customer demographics, preferences, needs, and buying habits to identify potential markets and factors affecting product demand.
- Measure the effectiveness of marketing, advertising, and communications programs and strategies.
- Develop and implement procedures for identifying advertising needs.
- Maintained upkeep in storage units and Mods.
Candidate Info
4
years in workforce
2
years at this job
HS
High School Diploma
Enrollment Specialist
- Review/Verify confidential documents submitted by applicants, by following guidelines, to determine initial eligibility for IDNYC card.
- Discreetly and confidentially enroll applicants for the IDNYC card on a daily basis.
- Provided direction/information onsite by answering questions/having individual in person conversations with perspective applicants about the IDNYC card.
- Enroll eligible applicants for IDNYC card.
Candidate Info
4
years in workforce
3
months at this job
C
Gerontology Administration
MA
Healthcare Administration
Enrollment Specialist Intern
- Worked with senior level executives in the development of portal strategies to manage patient appointment system
- Enrolled over 300 patients in the personal health record program
- Attended labor management board meetings to discuss Joint Commission Survey preparedness and strategic planning
- Attended nurse coaching meetings with program coordinator from Brooklyn Health Information Exchange
- Took part in educational seminars at Greater New York Hospital Association
Candidate Info
25
years in workforce
5
months at this job
Open Enrollment Specialist
- Educated members and potential members about the Medicare open enrollment period
- Informed members about any applicable plans, changes and charges
- Explained benefit details and policy guidelines to members during the open enrollment period
- Participated in ongoing training in the understanding and utilization of each benefit information
- Remained up-to-date on premium deduction schedules
- Acted as a liaison between the member and health plan sales representative or brokers as needed
- Inquire on the members satisfaction with their existing plan
Candidate Info
7
years in workforce
3
years at this job
Enrollment Specialist
- Accomplishes daily enrollment/disenrollment transactions
- Receive incoming member applications and/or obtain missing information if needed.
- Implements root cause analysis to determine issues related to beneficiary
- Performs daily, weekly and monthly reconciliation of membership against plan record and CMS.
- Follows all HIPAA Law and Procedures
Candidate Info
8
years in workforce
4
years at this job
Enrollment Specialist
- Maintained accurate and detailed records, including staff and child files on enrollments, attendance, health and safety, emergency contact information and incident reports.
- Travel to different states to assist with enrollment at new centers.
- Communicated with parents through enrollment, tours, newsletters, conferences and direct personal communication.
- Interviewed parents and children for enrollment.
- Compiled quarterly budget reports, financial spreadsheets and organizational charts to improve office organization.
- Monitored students' educational progress with individual charts and files.
- Supervised a group of teachers throughout the year.
Candidate Info
7
months in workforce
3
months at this job
AS
Business Administration
Billing & Enrollment Specialist
- Review incorrect payment information on file and make corrections based on customer preferences collected via telephone or enrollment applications
- Analyzing and making corrections to member accounts, with goal of one-step resolution
- Reconciliation of member accounts by reallocating funds to balance, issuing refunds if applicable, and settling deceased member accounts.
- Basic administrative duties such as time keeping, task tracking, productivity, and daily quality evaluation
Candidate Info
2
years in workforce
6
months at this job
BA
Psychology
Medicare Enrollment Specialist
- Working in an outsource position with BlueCross BlueShield of Tennessee
- Conducting business with potential as well as current members of BlueCross BlueShield Medicare plans
- In charge of the enrollment process for Medicare Advantage plans as well as Medicare supplement plans
- Handling highly sensitive information on a day to day basis
Candidate Info
8
years in workforce
6
months at this job
C
Business Core Concepts
BS
Psychology
MA
Organizational Leadership
Enrollment Specialist
- Process creditable coverage attestations
- Make outbound calls to members to complete the application process
- Use attention to detail to ensure accuracy
- Reconcile membership files
- Calculate gaps in Part D coverage to establish potential late enrollment penalties (LEP's)
- Serves as a liaison between [company name] and CMS
- Maintains weekly production expectations of 8-10 inquiries per hour
Candidate Info
8
years in workforce
3
years at this job
BA
Interdisciplinary Studies-human Resources
Enrollment Specialist
- Maintain and process enrollment data, schedules in PowerSchools, and immunization records through MCIR
- Enter drop/adds and sustain student files in PowerSchools
- Manage transcripts for current students and graduates
- Advise students on issues such as course selection, progress toward graduation, and career decisions
Candidate Info
2
years in workforce
2
years at this job
Three Years
Enrollment Specialist
- Enrolls employees from various companies for health insurance.
- Enrollments also vary as the companies send us multiple employees at once.
- Has communication with point of contacts, consumers and brokers.
- Completes enrollments in a timely manner, with excellent quality.
- Customer service skills.
- Makes contact with BCBS and HPHC.
Candidate Info
5
years in workforce
1
year at this job
Health Science
Enrollment Specialist
- Interpret and respond to student inquiries, vie telephone and electronically, regarding admissions and registration policies and procedures.
- Process admission applications from prospective students.
- Provide computer navigation support to students for Online MBA and Distance Learning business administration programs.
- Create student master files by entering information from the admissions application into the student database
- Answer calls regarding specific MBA programs, respond to requests for more information on a series of topics including registration, financial aid, scholarships, and advising.
- Perform office support duties
- Orient newly hired staff in the use of the college computer database and partner hosted websites.
Candidate Info
6
years in workforce
4
months at this job
HS
High School Diploma
Enrollment Specialist
- Educate clients about HIP, Hoosier Healthwise, and the Marketplace
- Enroll clients in state based insurance and the Obamacare Marketplace
- Case management with clients to keep them on track to get approved for insurance
- Attend Continuing Education classes, and webinar to stay up to date
Candidate Info
7
years in workforce
3
months at this job
BS
Human Development And Community Engagement
Enrollment Specialist
- Recruited high school students to the organization's program
- Plan and assist with afterschool workshop sessions geared towards college readiness
- Research and promote opportunities for students' post-secondary careers
- Record student information through the organization's online copilot database system.
Enrollment Specialist Resume Success Stories
