Enrollment Services Coordinator - WI Based Work From Home

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Under the general supervision of the Enrollment Manager, the Enrollment Services Coordinator is the day-to-day customer service representative for members who contact LCI with questions related to member payments or obligations. The Enrollment Services Coordinator will have a comprehensive understanding of Medicaid eligibility for Family Care and payments members are liable for to effectively navigate questions from members or LCI staff. In fulfilling these duties, the Enrollment Services Coordinator works collaboratively with Lakeland Care, Inc.’s (LCI) Care Management (CM) staff, LCI Enrollment staff, LCI Accounting department and county Income Maintenance staff to ensure that we appropriately invoice members for obligations owed to Lakeland Care. 

Essential Competencies:

Accountability

• Primary and main point of contact to respond to calls or email inquiries from members or LCI staff within 24 business hours related to member payments or obligations.
• Prepare fiscal letters for any new member enrolling with LCI or when there is a change reported for a member that will impact their monthly obligation to LCI.
• Set up payment plans for members when they have a past due balance and assist with processing member payments.
• Assist in reviewing Change Routing Forms to ensure accuracy before processing internally.
• Assist in managing and scheduling MA renewal calls for members in collaboration with the Member Enrollment Specialists.

Critical Thinking

• Independently problem solve for member concerns or issues that arise by using the most appropriate internal resources for information.
• Ability to navigate multiple databases to effectively problem-solve while on a call with a member or representative.
• Assist with year-end reconciliations, including participation in the audit process either monthly or quarterly, when needed.
• Ability to identify issues or concerns and provide solution focused ideas to address or solve the issues at hand.

Commitment to Excellence

• Participate in trainings or informational sessions to ensure familiarity with state and federal regulations updates or changes that may impact member obligations or Medicaid eligibility.
• Be knowledgeable of the Family Care contract and Medicaid Handbook expectations related to member eligibility and obligations.
• Provide feedback internally to the enrollment department and other departments within LCI when barriers or process gaps are identified that is impacting member billing.
• Assist in the development of workflows, processes and policies related to member share. 
• Provide back-up to the Enrollment Services Associate to process member enrollments and disenrollments timely, when needed.

Interpersonal Awareness

• Provide exceptional customer service to members as the main point of contact regarding their member share obligations. 
• Exhibit the ability to understand and manage personal emotions, as well as the emotions of others.
• Ability to calmly handle difficult conversations with members and/or their representatives related to member obligations or past due balances.

Relationship Building

• Provide support and education to members and LCI staff related to member obligations for cost share, patient liability and room and board.
• Serve as a liaison between Member Share staff and LCIs Accounting Department to assist members in resolving any questions that arise related to member billing.
• Work collaboratively with LCI’s CM and Enrollment staff, county Income Maintenance staff, and members to resolve discrepancies between LCI’s IT system, the state’s CARES system, and the state’s Forward Health Interchange.

Organizational Regard

• Maintain the confidentiality of client information and protected health information as required by State and Federal regulations, including the Health Insurance Portability and Accountability (HIPAA) Act of 1996. 
• Comply with applicable federal and state laws, administrative rules, established organizational procedures and accepted professional standards. 

Qualifications:

• Three years of customer service and/or client billing experience with demonstrated ability to analyze and work independently. (Associate degree in accounting or business-related field a plus)  
• Knowledge or experience with the State of Wisconsin’s CARES or ForwardHealth systems is beneficial.
• Working knowledge of computers, computer programs, typing, and data entry to include working knowledge of Microsoft Excel and Microsoft Word.
• Excellent customer service skills demonstrated by pleasant, patient and professional interaction and customer care techniques.
• Ability to understand and use advisory data and information such as financial statements, technical operating manuals, procedures, guidelines, non-routine correspondence, and laws. 
• Strong listening, verbal, and written communication skills.
• Effective problem-solving and mediation skills.
• Effective organizational and time management skills. 
• Self-starter with strong desire to learn.
• Current driver’s license, acceptable driving record and proof of adequate insurance required.

In evaluating candidates for this position, Lakeland Care may consider a combination of education, training and experience which provides the necessary knowledge, skills and abilities to perform the duties of the position.