Medicare Enrollment Specialist; DE- Kyle Campus

Medicare Enrollment Specialist (DE1202 - Kyle Campus) – Communi Care

Responsible for educating senior patients on Medicare, Medicare Saving Programs (MSP), providing resources to applicable patients, determining eligibility for MSPs, processing enrollment applications for applicable programs, and attending outreach events. The individual will facilitate consumer enrollment and assist qualified individuals in making informed decisions about Medicare options and MSPs, when available. Services are provided to all consumers, including but not limited to Communi Care patients and area residents 60 years and older, especially under‑represented and uninsured residents.

The role also includes managing patient accounts, assisting with account summarization, and connecting patients to Communi Care’s Medicare Advantage partner when appropriate.

The Medicare Enrollment Specialist must complete 12 hours of approved training annually to stay up‑to‑date on all Medicare guidelines and regulations and to provide accurate assistance to patients.

• Perform screenings on patients near Medicare eligibility to ensure a seamless process and to assess eligibility for Medicare Savings Programs; assist with application completion and place clients on appropriate programs based on funding source requirements.
• Maintain knowledge and expertise in eligibility, enrollment, and program specifications of Medicare and Medicare Savings Programs.
• Conduct in‑reach, outreach, and education activities to inform Communi Care patients, consumers, businesses, community organizations, and other stakeholders about Medicare and ancillary Medicare programs.
• Perform follow‑up eligibility processes by contacting patients for additional information and the funding source for eligibility status.
• Ensure protection and security of consumers’ personal, confidential, and identifiable information in accordance with HIPAA.
• Conduct in‑person scheduled meetings with patients and/or family members to provide education and resources on available Medicare insurance plans and to complete applications as applicable.
• Ensure accurate activation of plans and programs, record special notations in patient account software, and assist patients with registration.
• Plan and execute quarterly Medicare Education Sessions for all patients and area residents with the Medicare Enrollment Team.
• Provide excellent internal/external customer service via telephone, fax, or face‑to‑face contact to assist patients with their health care needs.
• Maintain a daily log of all activities performed, including volume of work, grant productivity numbers, account balance arrangements, new patient registrations, and other assistance provided; submit logs to the department manager for review.
• Perform other related duties as assigned.

• High School diploma or equivalent.
• Minimum two (2) years’ experience working with Medicare and the Medicare population.
• Bilingual in English/Spanish (required).
• Working knowledge of Medicare, Texas Medicare Savings Programs, and understanding of Medicare Advantage plans.
• Computer skills;
  Word, Excel, Internet/Intranet.
• Scheduled hours and/or work locations are subject to change.

• Finger Dexterity:
  Using fingers for small movements such as typing or picking up small objects.
• Talking:
  Frequently conveying detailed or important instructions or ideas accurately, clearly, or quickly.
• Hearing:
  Able to hear average or normal conversations and receive ordinary information.
• Repetitive Motions:
  Frequently and regularly using the wrists, hands, and fingers.
• Visual:
  Average, ordinary visual acuity necessary to prepare or inspect documents or other materials.
• Physical:
  Physical work involving bending, stooping, and reaching high areas for charts; excessive walking and standing most of the time. May be required to lift folders, files, papers, and other items weighing up to approximately 25 lbs.

• Entry level

• Full‑time

• Other

• Hospitals and Health Care