Title: Enrollment Specialist - 3 roles are open

ALTA is supporting a contract opportunity working 100% remote.

ALTA IT Services is a wholly owned subsidiary of System One, a leading provider of specialized workforce solutions and integrated services. ALTA is an established leader in IT Staffing and Services, for both government and commercial enterprises across the United States, specializing in Program & Project Management, Application Development, Cybersecurity, Data & Advanced Analytics, and Agile Transformation Services.

Job Description:

• Process work items according to appropriate regulatory guidelines

• Interpret data, analyze results using statistical techniques

• Completion of daily and monthly pre-processor exceptions in an accurate manner and in accordance with stated service level agreements.

• Analyze member eligibility and take appropriate actions to resolve issues across all eligibility systems

• Completion of all daily and monthly eligibility loading reports in an accurate manner and in accordance with stated service level agreements

• Identify, analyze, and interpret trends or patterns in complex data sets

• Process mass Primary Care Physician (PCP) changes with Provider Operations

• Research and respond to eligibility inquiries from contracted vendors

• Filter data and review reports to locate and correct code problems in the pre-processor

• Process paper applications received for all applicable lines of business

• Inbound phone coverage to answer inquiries from both internal and external customers

• Make outbound phone calls in support of Enrollment processes

• Work closely with management to prioritize business needs

• Locate and define new process improvement opportunities

• Complete all required corporate training within stated timelines to a satisfactory manner

• Access state and federal government systems to review and confirm eligibility status

• Subject Matter Expert for the line of business they are supporting

• Perform any other job related instructions, as requested

  Education and Experience:

• High School Diploma or equivalent required

• Associate’s degree in accounting, finance or business related field or equivalent work experience is preferred

• Minimum of three (3) years of healthcare, insurance, or related industry experience to include at least two (2) years of enrollment/eligibility or similar experience is required

  Required Competencies, Knowledge and Skills:

• Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy

• Strong knowledge and experience of Microsoft Word and Excel

• Excellent verbal and written communication skills

• Ability to work independently and within a team environment

• Attention to detail

• Strong knowledge of the healthcare field

• Strong knowledge and experience of Medicaid and Medicare preferred

• Critical listening and thinking skills

• Proper grammar usage

• Time management skills

• Proper phone etiquette

• Customer service oriented

• Multitasking skills

• Critical Thinker/problem solver

  Licensure and Certification:

• None

  For immediate consideration please email Patrick Jackson at pjackson@altaits.com

  Ref: #860-IT Cincinnati

System One, and its subsidiaries including Joulé, ALTA IT Services, CM Access, TPGS, and MOUNTAIN, LTD., are leaders in delivering workforce solutions and integrated services across North America. We help clients get work done more efficiently and economically, without compromising quality. System One not only serves as a valued partner for our clients, but we offer eligible full-time employees health and welfare benefits coverage options including medical, dental, vision, spending accounts, life insurance, voluntary plans, as well as participation in a 401(k) plan.

System One is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, age, national origin, disability, family care or medical leave status, genetic information, veteran status, marital status, or any other characteristic protected by applicable federal, state, or local law.