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Enrollment Technician

Dignity Health Management Services Bakersfield, California
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The posted compensation range of $23.00 - $29.05 /hour is a reasonable estimate that extends from the lowest to the highest pay CommonSpirit in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. CommonSpirit may ultimately pay more or less than the posted range as permitted by law.

Requisition ID 2024-388371 Employment Type Full Time Department Decision Support / Financial Plan Hours/Pay Period 80 Shift Day Weekly Schedule Monday-Friday 8-5PM Remote Yes Category Managed Care
Overview

The purpose of Dignity Health Management Services Organization (Dignity Health MSO) is to build a system-wide integrated physician-centric full-service management service organization structure. We offer a menu of management and business services that will leverage economies of scale across provider types and geographies and will lead the effort in developing Dignity Health’s Medicaid population health care management pathways. Dignity Health MSO is dedicated to providing quality managed care administrative and clinical services to medical groups hospitals health plans and employers with a business objective to excel in coordinating patient care in a manner that supports containing costs while continually improving quality of care and levels of service. Dignity Health MSO accomplishes this by capitalizing on industry-leading technology and integrated administrative systems powered by local human resources that put patient care first.

Dignity Health MSO offers an outstanding Total Rewards package that integrates competitive pay with a state-of-the-art flexible Health & Welfare benefits package. Our cafeteria-style benefit program gives employees the ability to choose the benefits they want from a variety of options including medical dental and vision plans for the employee and their dependents Health Spending Account (HSA) Life Insurance and Long Term Disability. We also offer a 401k retirement plan with a generous employer-match. Other benefits include Paid Time Off and Sick Leave.


Responsibilities

***This position is remote with the ideal candidate residing within California, or willing to work PST business hours.

Position Summary:


Coordinate the membership enrollment process for various health plans to ensure information is accurately recorded and entered timely according to department guidelines. Responsible for reconciling membership against capitation payments received from delegated health plans.


Responsibilities may include:
- Processes enrollment/eligibility files for all lines of business.
- Reconciles membership to the capitation payments received from the delegated lines of business.
- Contacts health plans and/or employer groups to resolve questions on member enrollment.
- Verifies Primary Care Physicians and effective dates. Confirms member information including coverage and termination effective dates, member address and plan benefits.
- Responds to general inquiries or questions in the area of eligibility.
- Maintains and processes eligibility files within the database to ensure information is accurate.
- Supports Configuration partners (Contracting and Benefits) with various tasks to ensure department goals are met in a timely manner.


Qualifications

***This position may be filled at a level I, II or III, dependent upon the qualifications of the final candidate. Additional qualifications needed include 5-7+ years of experience and demonstrated experience in handling complex enrollment and eligibility processes, as well as an Associates or Bachelors degree or equivalent experience (3-5 additional years of related job or industry experience).

Minimum Qualifications:


- 3+ years in an administrative role w/ related experience (ie: office admin support, insurance services, customer service, etc.)
- High School Diploma or GED

Preferred Qualifications:


- 3+ years of related experience in the Managed Care/Healthcare Industry preferred.
- Associates or Bachelor's Degree in Business Administration or other related field preferred.
- Certification in Healthcare Administration or Managed Care preferred.
- Advanced Excel skills, including pivot tables, VLOOKUP, and data analysis functions preferred.
- Experience with process improvement methodologies (e.g., Lean, Six Sigma) preferred.

- Health plan experience strongly preferred.

- Experience with insurance eligibility verification strongly preferred.

Unless directed by a Collective Bargaining Agreement, applications for this position will be considered on a rolling basis. CommonSpirit Health cannot anticipate the date by which a successful candidate may be identified.

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Depending on the position offered, CommonSpirit Health offers a generous benefit package, including but not limited to medical, prescription drug, dental, vision plans, life insurance, paid time off (full-time benefit eligible employees may receive a minimum of 14 paid time off days, including holidays annually), tuition reimbursement, retirement plan benefit(s) including, but not limited to, 401(k), 403(b), and other defined benefits offerings, as may be amended from time to time. For more information, please visit https://www.commonspirit.careers/benefits.

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Equal Opportunity

CommonSpirit Health™ is an Equal Opportunity/Affirmative Action employer committed to a diverse and inclusive workforce. All qualified applicants will be considered for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, marital status, parental status, ancestry, veteran status, genetic information, or any other characteristic protected by law. For more information about your EEO rights as an applicant, please click here [PDF].

CommonSpirit Health™ will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c). External hires must pass a post-offer, pre-employment background check/drug screen. Qualified applicants with an arrest and/or conviction will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, ban the box laws, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances. If you need a reasonable accommodation for any part of the employment process, please contact us by telephone at (415) 438-5575 and let us know the nature of your request. We will only respond to messages left that involve a request for a reasonable accommodation in the application process. We will accommodate the needs of any qualified candidate who requests a reasonable accommodation under the Americans with Disabilities Act (ADA). CommonSpirit Health™ participates in E-Verify.