Temporary Enrollment Specialist I

Summary: Partnership HealthPlan of California is seeking a Temporary Enrollment Specialist I to assist in maintaining Medi-Cal membership. The role involves processing eligibility issues, managing member records, and ensuring proper primary care physician assignments while adhering to quality standards. Responsibilities: - Processes PCP assignments and reports - Reviews and responds to eligibility questions and issues - Processes a variety of membership reports to ensure members records as well as PCP assignments are appropriate - Monitors the E-Unit inbox and processes all Medi-Cal eligibility related questions and requests - Maintains and processes out of area requests - Processes all related newborn add requests etc - Participates in special projects, tasks, and assignments, as needed - Processes duplicates records - Communicates with county contacts to correct membership records, aid codes or other eligibility discrepancies at the county level - Arranges face to face interpreting and reconciles invoices - Processes “no show” appointment requests - Supports and assists team members in their daily duties as needed - Other duties as assigned Required Qualifications: - High School Diploma or equivalent - one (1) year experience in health care or Medi-Cal or Medicaid eligibility - Thorough knowledge of managed care and Member Services Policies and Enrollment Unit procedures - Excellent understanding of all Partnership policies and procedures relating to all aspects of care - Excellent understanding of external agencies that provide services to Partnership members - Strong understanding about the Medi-Cal eligibility process - Working knowledge of business software applications - Proficient use of computer keyboard to access data - Effective written communication skills - Excellent organization skills with ability to prioritize assignments and meet deadlines - Ability to use good judgment within the scope of authority and to handle confidential and sensitive issues with tact and diplomacy - Ability to stay focused on repetitive work and meet production and quality standards - Ability to understand and follow instructions - Must have excellent organization skills and be detail oriented with a high level of accuracy - Ability to lift, carry, or move objects of varying size, weighing up to 10 lbs - Ability to use multiple computer monitors, headsets, and keyboard to accomplish tasks Preferred Qualifications: - Customer service experience - Bilingual skills in Spanish, Tagalog, or Russian Required Skills: Medi-Cal eligibility process, Managed care policies, Member Services policies, Enrollment Unit procedures, Business software applications, Data entry, Bilingual skills in Spanish, Bilingual skills in Tagalog, Bilingual skills in Russian