Enrollment Specialist

Enrollment Specialist

Job Purpose

The Electronic Visit Verification (EVV) and Facility Enrollment Specialist is responsible for facilitating the enrollment of insureds who receive home care and facility services from provider agencies, independent caregivers, and facilities into the EVV and/or Facility program. This position primarily conducts outbound and inbound telephone outreach to educate stakeholders, guide them through the enrollment process, resolve questions, and ensure all enrollment requirements are completed accurately and timely.

The ideal candidate possesses strong communication, customer service, and organizational skills, with the ability to effectively manage multiple cases while maintaining compliance with applicable state, federal, and program requirements.

Duties/Responsibilities:

• Conduct high-volume outbound and inbound phone calls to insureds, provider agencies, caregivers, and independent providers regarding EVV enrollment.
• Educate callers on EVV program requirements, enrollment procedures, deadlines, and available support resources.
• Guide stakeholders through the enrollment process, ensuring all required information and documentation are obtained.
• Assist providers with complete enrollment forms, account setup, and system access.
• Verify enrollment information for accuracy and completeness.
• Document all customer interactions, enrollment activities, and case notes in the appropriate systems.
• Follow up with insureds and providers to obtain missing information and ensure timely completion of enrollment.
• Respond professionally to questions, concerns, and enrollment issues while providing exceptional customer service.
• Coordinate with internal departments and external partners to resolve enrollment-related issues.
• Monitor assigned enrollment cases and meet established productivity, quality, and service-level expectations.
• Maintain confidentiality of protected health information (PHI) and comply with HIPAA and all applicable state and federal regulations.
• Stay current on EVV program requirements, policies, and system updates.
• Build and maintain strong client relationships to ensure satisfaction and compliance with EVV requirements.
• Provide training and guidance to clients on the use of EVV and Facility platforms, tools, and processes.
• Gather required information from claimants and caregivers and accurately record data in Wellcove’s platforms/systems.
• Maintain organized documentation for all client interactions, training sessions, and compliance activities.
• Provide outstanding customer service via phone and email, displaying professionalism, empathy, a sense of urgency, and a genuine willingness to help.
• Independently process caller requests accurately and promptly in Wellcove’s proprietary system and escalate as appropriate.
• Comply with customer support objectives and performance standards
• Effective use process resources to gain knowledge base and ensure the delivery of accurate information and error-free processing of requests
• Willingness to learn new duties and technology-related skills as required.

Required Skills/Abilities:

• Proficiency with Microsoft office applications, Nitro, and the ability to learn multiple software applications.
• Accountable and able to work remotely and independently.
• Displays a positive ‘can do’/customer-first attitude.
• Ability to accurately document customer responses while simultaneously speaking with customers.
• Excellent communication skills and appropriate etiquette, great phone manners, and ability to speak with a wide range of personalities. Demonstrate a high level of proficiency in the use of the English language in oral and written forms.
• Collaborative team spirit.
• Ability to explain complex processes in a clear and easy-to-understand manner.
• Knowledge of HIPAA privacy requirements and confidentiality standards.
• Ability to meet performance metrics related to call volume, quality, and enrollment activation.
• Must have a dedicated remote work location free from background noises, interruptions, and desk clutter.
• Must have reliable internet connection and access to a smart phone.

Education and Experience:

• High School or GED required
• Bachelor’s Degree, or equivalent combination of education, training, and experience preferred.

Physical Requirements:

• Sedentary work. Repetitive motion. Substantial movements (motions) of the wrists, hands, and/or fingers.

• Primarily remote call-center environment.
• Extensive telephone communication throughout the workday.
• Frequent computer use for documentation and enrollment processing.
• May require occasional overtime based on program or enrollment deadlines.

At Wellcove, we strive to create an inclusive culture for all. We understand the importance of listening and incorporating various perspectives at every level of service. Our company does not discriminate based on gender identity, race, sexual orientation, age, religion, or disability.