Insurance Career Spotlight – Healthcare Insurance Enrollment Specialist

A healthcare enrollment specialist generally works at a medical facility, such as a private practice, assisted care facility, hospital or clinic. The enrollment specialist determines if a patient is eligible for medical care, checking with insurance companies to see if a patient is eligible for treatment; then gives approval to provide the treatment. The enrollment specialist also deals with providers to determine the status of claims.

The enrollment specialist can also suggest programs or treatments that might apply to a particular patient. He or she also assists patients with information about the patient’s account and helps to resolve other problems, as well as helping to educate patients and clients about enrollment eligibility.

Handling records is also part of the job. The enrollment specialist may be asked to acquire patient records and oversee the filing of enrollment forms and other documents.

Skills Needed

An enrollment specialist must be comfortable and effective at using the telephone and email to communicate. They should also be skillful at using electronic medical record systems because they may have to access patient records through these types of systems.

At some organizations, enrollment specialists also perform duties like checking in patients, scheduling appointments, answering phone calls and preparing patient charts. Some enrollment specialists also help patients enroll in insurance programs and other healthcare programs online.

Requirements

Many enrollment specialist positions require healthcare experience, including experience working with the Affordable Care Act and other benefits plans, and knowledge of medical terminology. Some organizations may require a college degree, while others may require some type of nursing certification. Some, however, may only require a high school degree.

The tasks that enrollment specialists perform include entering, updating and reviewing data; understanding, explaining and documenting Medicare and Medicaid coverage; and analyzing data to identify healthcare trends.

Pay

The average hourly wage for healthcare enrollment specialists is $15.75, according to PayScale.com. Job experience is the most significant factor in determining salary. Geography also has an effect. Most enrollment specialists also receive medical and dental coverage from their employers.

About Insurance Relief

At Insurance Relief, we understand your unique skills and needs. We have vast experience in the insurance arena. We work with brokers, carriers and third-party administrators to locate and place the best people for positions ranging from entry level to senior management. We take the time to truly understand what you want to accomplish, and then do our best to find meaningful opportunities for you. If you are an insurance professional looking for employment, give Insurance Relief a call today for this job or one of the other many jobs available.