Enrollment Data Coordinator - 154173

Community Health Choice, Inc. (Community) is a non-profit Health Maintenance Organization (HMO) licensed by the Texas Department of Insurance. Through its network of more than 10,000 providers and 70 hospitals, Community serves over 260,000 Members with the following programs:

Medicaid State of Texas Access Reform (STAR) program for low-income children and pregnant women

Childrens Health Insurance Program (CHIP) for the children of low-income parents, which includes CHIP Perinatal benefits for unborn children of pregnant women who do not qualify for Medicaid STAR

Health Insurance Marketplace Plans that offer individual health coverage that includes preventive care, emergency services, prescription drugs, and hospitalization available to all, regardless of pre-existing conditions.

Improving Members' experiences is at the heart of every Community position. We strive every day to make sure that our Members have access to the high-quality health care they need and deserve.

Community is accredited by URAC for its health plan operations. We offer care management programs for asthma, diabetes, and high-risk pregnancy. An affiliate of the Harris Health System (Harris Health), Community is financially self-sufficient and receives no financial support from Harris Health or from Harris County taxpayers.

The Enrollment Data Coordinator serves as the initial support for the Eligibility department and delivers excellent customer service and meet both organization and state guidelines and requirements. Assists Eligibility Analyst, Senior analyst, Supervisor and Director of Operations with all duties pertaining to member eligibility.

QUALIFICATIONS:

• High School Graduate with two or more years of extensive experience within the medical field, preferably in the managed care and or Medicaid industry.
• Two years experience in a Health Care Call Center/Member Services Dept. with extensive group health insurance and Medicaid knowledge including but not limited to: claims, eligibility, cob, benefits, value added and vendor benefits, state entities, requirements and regulations.

OTHER SKILLS:

• Extensive knowledge of the Medicaid Product and or CHIP products, Eligibility and Benefits.
• Above Average Verbal (Heavy Public Contact)
• Writing /Composing/(Correspondence/Reports)
• Analytical, Mathematics, Research, Statistical, MS Word, MS Excel
• Multi-tasker with excellent mathematic and analytical skills

Community employees benefits are provided by Harris Health. These benefits are designed to provide you with flexibility and choices in meeting your specific needs.

Community is an Equal Opportunity Employer.

Clerical and Administrative Support