Enrollment Coordinator

Job Overview:

The Enrollment Coordinator supports the Enrollment team by ensuring the accuracy, completeness, and timely processing of all administrative components related to new member enrollment. This role works closely with Enrollment Nurses to audit case work, coordinate completion of the Person-Centered Service Plan (PCSP), and process all required new enrollee authorizations prior to enrollment. The primary goal is to ensure that every enrollment is complete, compliant, and ready for timely service initiation.

Essential Responsibilities:

Enrollment Audit & Quality Assurance Perform detailed audits of Enrollment Nurse files to ensure all required components are completely accurately: NA Script completed Plan of Care (POC) matches Task Tool (TT) Caregivers and PCP entered correctly CDPAS forms uploaded DME requests submitted SDC providers are within network

RHIO/HCP

forms completed and uploaded Verify all required documentation is signed and received from the member Identify discrepancies and communicate corrections to Enrollment Nurses in a timely manner Document in Salesforce all outcomes Escalate unresolved issues or trends to supervisor PCSP Coordination & Completion Assist Enrollment Nurses in compiling all required components of the Person-Centered-Service Plan (PCSP) Track and follow up on missing information needed for PCSP completion Ensure all PCSPs are: Complete, Sent to the Member for Signature, Sent to the Provider and Uploaded within required timeframes Coordinate closely with nurses to resolve gaps and ensure timely submission Report delays, barriers, or recurring deficiencies New Enrollee Authorization Processing Prepare and send all required authorizations prior to member enrollment date Ensure authorizations align with approved Plan of Care Communicate with providers to confirm receipt of authorizations Document all authorization activity in member records Follow up on any missing confirmations or discrepancies Support non-clinical corrections to new enrollee authorizations as needed