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Enrollment / Eligibility Specialist
Saint Joseph, MO

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IMKO Exec Search

Enrollment Specialist

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Job Description

Enrollment Specialist Coverage decisions decide whether care is paid for or written off. In this role, you turn incomplete eligibility into funded accounts—protecting cash flow for hospitals and large physician groups while keeping patients out of avoidable balances. You will be measured by enrollments that stick, not by calls completed. Performance Objectives Secure primary and secondary coverage by completing accurate, payer-ready enrollment packages within agreed turnaround times. Close eligibility gaps—missing documents, mismatched demographics, lapsed coverage—so accounts move from uninsured or underinsured to billable status. Cut downstream denials and aged receivables by confirming benefits, effective dates, and coordination of benefits before handoff. Identify Medicaid, out-of-state Medicaid, and secondary-program opportunities and route each case to the correct path on first review. Obtain complete financial and demographic information from patients and facilities through clear, respectful conversations. Hit daily production and quality targets for accuracy, completeness, and rework rate, with every action documented for audit and follow-up. Escalate complex payer rules and client-specific exceptions early so enrollment does not stall cash. Environment & Resources You will work inside a specialized revenue-cycle operation serving hospitals and large practices—alongside insurance discovery, denial management, and receivables follow-up. Tools include payer portals, enrollment workflows, and secure documentation systems. You report to enrollment leadership and partner with client liaisons; success depends on disciplined queues, quality review, and HIPAA-safe handling of patient financial data—not on a personal book of business. Essential Qualifications Hands-on experience completing Medicaid, Medicare, commercial, or hospital financial-assistance enrollments to payer standards. Proven ability to read coverage rules and submit complete applications without repeat defects. Clear phone and written communication with patients facing medical bills and with clinical or business-office staff. Track record meeting production and quality metrics in a measured healthcare or revenue-cycle setting. Working knowledge of coordination of benefits, effective dates, and why bad eligibility creates denials. Consistent compliance with privacy rules when collecting and storing financial and demographic data. Role Selling Points Specialized enrollment work—primary, secondary, and Medicaid pathways—not a generic call-center script.
Visible impact:
your files accelerate cash and reduce patient financial friction. Breadth across the revenue cycle, with clear handoffs to discovery, denial, and follow-up teams. A growth-stage healthcare services environment where accuracy and patient experience are the standard, not an afterthought. Call to Action If you can get coverage right the first time and stand behind the numbers, apply now. Bring examples of enrollment volume, accuracy, and the payers you know. #INDLOXO

Benefits

  • Dental Insurance