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Enrollment Specialist
Denver Health
| Job Summary Under general supervision, determines medical assistance eligibility for patients/clients in hospital outpatient/ inpatient, and emergency settings, as well as face-to-face and in a call center environment. Enrollment Specialists assist patients/clients with submitting/processing documentation to complete applications and forms for various medical assistance programs. Collaborate directly with both internal and external partners such as State entities, other departments and community organizations. Complete accurate data entry into multiple Federal, State and internal systems.
Responsibilities 1. Effectively and accurately follows established work procedures and guidelines to be efficient in the Medicaid case maintenance and redetermination processes. Includes application completion, collection of all documentation, data entry into CBMS, including detailed case comments. 2. Understands and maintains a working knowledge of Medicaid, CHP+, CICP, DFAP, and Connect for Health Colorado policies to ensure accurate program approvals. 3. Interviews patients/clients to determine living and financial situation, calculates applicable income and assets, and determines eligibility for appropriate medical assistance programs. 4. Identifies, researches, and resolves complex problems related to eligibility determinations for various medical assistance programs. 5. Receives, processes, and verifies CHP+ enrollment fees and Medicaid Buy-In premium payments. 6. Collects data utilizing various tracking tools that have been developed to monitor performance. 7. Ensures confidentiality of patient information by creating and maintaining a secure and trusting environment by not sharing information learned on the job, except when necessary in the performance of the job responsibilities or to improve a patient's care. 8. Promotes positive interpersonal relationships with fellow employees, physicians, patients and visitors. Treats all individuals with courtesy, dignity, empathy, and respect; consistently displays courteous and respectful verbal and non-verbal communications. 9. Completes all duties and responsibilities in a non-discriminatory manner regardless of age group(s), cultures, religions, gender, race, and sexual orientation of the patients/clients to whom service is being provided. 10. Attends all department related meetings, trainings, and coaching. 11. Complies with and demonstrates support for the vision, mission, and values of Denver Health. Supports and adheres to the Denver Health Code of Conduct. 12. Clearly explains the various medical assistance programs to patients/clients and assists them in completing the necessary forms to apply for such programs. 13. Maintains a professional appearance in accordance with the Denver Health Dress Code policy. 14. Maintains regular and predictable attendance in accordance with the Denver Health Attendance policy. 15. Other duties as assigned.
Knowledge, Skills & Abilities 1. Knowledge of medical and/or public assistance programs including Medicaid, CHP+, CICP, DFAP, and Connect of Health Colorado health plans. 2. Knowledge of the eligibility determination system CBMS. 3. Knowledge of federal and Colorado statutes, legislative initiatives and regulations, as well as federal, State and local policies. 4. Skilled in analytical thinking, problem solving, and process improvement. 5. Skilled in providing excellent customer service. 6. Skilled in working in a call center environment. 7. Ability to communicate orally and in writing in a thorough, clear, and professional manner. 8. Ability to simultaneously coordinate and manage several functions, programs, and tasks in various stages of completion. 9. Ability to consistently implement program, department and organizational policies and procedures. 10. Ability to work well in teams and independently to get projects done, and to work with those at all levels of the organization. 11. Ability to adapt to change. 12. Bilingual preferred. Computers and Technology 1. Proficient in Microsoft Word, Excel, and Outlook. 2. Knowledge of CBMS, Epic, Salesforce, Five9 systems.
Education * Associate's Degree
Experience
Location Shift Work Type All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, efficient, high-quality academic health care system that is considered a model for the nation. The Denver Health system includes the Rocky Mountain Regional Level I Trauma Center, a 525-bed acute care medical center, Denver's 911 emergency medical response system, 8 family health centers, 15 school-based health centers, the Rocky Mountain Poison and Drug Center, the Denver Public Health Department, an HMO, and The Denver Health Foundation. As Colorado's primary safety net institution, Denver Health is a mission-driven organization that has provided more than $3.3 billion in care for the uninsured in the last ten years. Denver Health is a leader in performance and quality improvements and remains financially secure, in part, due to its nationally recognized implementation of lean principles in healthcare. Denver Health is a major resource to the community, serving approximately 185,000 individuals and 67,000 children a year. Located just south of downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer. We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE). "Denver Health is committed to provide equal treatment and equal employment opportunities to all applicants and employees. Denver Health is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, sex, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class."
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