Your career starts now. We're looking for the next generation of healthcare leaders.

At AmeriHealth Caritas, we're passionate about helping people get care, stay well, and build healthy communities. As one of the nation's leaders in healthcare solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services, and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Enrollment Specialist (Data entry)

Under the direct supervision of the Enrollment Supervisor, responsible for accurately updating member information in the Healthcare System to reflect State System eligibility and member demographics to ensure all members have access to care. Ability to review data and provide root cause analysis of identified issues to various levels of management and the State. Research fall-out records from the inbound eligibility load process to identify discrepancies and update members according to state and contractual requirements. Enters newborn records in the Healthcare System and facilitates processes for State notification of birth. Works with Finance to reconcile plan membership to ensure appropriate payments were received from the State. Ability to understand various processing rules and support multiple Lines of Business.

• Ensures the timely and accurate processing of member eligibility and demographic information in the Facets system as required. Assignments and updates include new enrollments, dis-enrollments, re-enrollments, category changes, demographic changes, and PCP updates. Follows internal processes and procedures to ensure activities are handled timely and in accordance with departmental and company policies/procedures.
• Update and track newborn records in Facets and various databases in accordance with each State's requirement. Submits appropriate information to the state for newborns to ensure timely processing of eligibility and payments.
• Demonstrates ability to distinguish between routine and significant matters; identifies when exceptions are in order and provides written documentation to support decision. Apprises management of issues, which can affect service. Effectively identify trends of member/provider issues related to information submitted.
• Assists internal customers with the verification of member enrollment and eligibility information by responding to requests and resolving all inquiries related to the member enrollment/dis-enrollment process.
• Review audit reports to assess and verify system-generated and file load process errors. Reconciles audit discrepancies, corrects errors in the system, and makes appropriate changes to avoid recurrence. Maintains thorough knowledge of enrollment process systems, databases, and subsystems.
• Maintains a tracking log of productivity on a daily basis. Assists department and company in managing member/group enrollment inventories by meeting deadlines daily.
• Create and support an environment that fosters teamwork, cooperation, respect, and diversity. Always establish and maintain positive communication and a professional demeanor with employees and clients. Adhere to policies and procedures. Demonstrates and supports commitment to corporate goals and mission.
• Performs other related duties and projects as assigned.

Education/Experience:

• High School diploma or GED required.
• Minimum one (1) year of experience performing data entry or relevant experience required.
• Prior experience in the healthcare or managed care industry preferred.
• Intermediate Microsoft Office skills, including Word, Excel, and Access.
• Excellent verbal and written communication skills.
• Ability to work both independently and in a team environment.

Diversity, Equity, and Inclusion

At Amerihealth Caritas, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

We keep our associates happy so they can focus on keeping our members healthy.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.