Planned Systems International

Enrollment Specialist

Location US-Remote
Posted Date 1 month ago(1/28/2024 2:02 PM)
Job ID
2024-10461

Overview

PURPOSE

To provide an Analyst II as an Enrollment Specialist to support services related to carrying out certain responsibilities focused on fulfilling the requirements established by P.L.111-347; the James Zadroga 9/11 Health and Compensation Act of 2010. On December 18, 2015, President Obama signed the James Zadroga 9/11 Health and Compensation Reauthorization Act which reauthorized the WTC Health Program for 75 years, ending in 2090.

 

SCOPE OF WORK

The contractor will provide an Analyst II (Enrollment Specialist) to provide services related to carrying out certain responsibilities of the Zadroga Act focusing on Member Service Activities. In particular reviewing applications and making eligibility determinations for the WTC Health Program. The selected candidate will be responsible making eligibility determinations in accordance with the Zadroga Act, working with the Program’s Health Support Contractor to receive the incoming applications, assigning applications for review and determinations, and other duties associated with Member Service Activities. The Analyst II (Enrollment  Specialist) would work alongside the Enrollment and Appeals Team Lead, public health advisors, and Health Support Contractor and will serve as a specialist for enrollments.  

The contractor is to maintain a healthy organizational culture in providing consistent and professional communication and services to WTC Health Program clients including health care beneficiaries and health care providers, the contractor shall participate in the occasionally held lunch/learn and other training sessions regarding WTC Health Program organizational culture.

 

Duties:

  • Serves as enrollment specialist, responsible for making enrollment decisions in accordance with the James Zadroga 9/11 Health and Compensation Act of 2010. The Analyst II is responsible for.
    • Knowledge and understanding of enrollment requirements under the Zadroga Act.
    • Import and download batches of applications received each week from the Health Support Contractor.
    • Assign enrollment requests/applications to other Member Services staff as appropriate.
    • Return enrollment decisions to the Health Support Contractor for completion of the enrollment decision process.
  • Works with the Health Support Contractor to resolve issues that may arise with enrollments/applications received for review.
  • Ensures that enrollment decisions are made in accordance with prescribed timelines and goals established by the Member Services and Enrollment Unit.
  • Cohesively works alongside Enrollment and Appeals Team Lead to complete enrollment decisions.
  • Other duties as requested.

 

Qualifications:

 

·         Bachelor’s degree; public health, healthcare, English, technical writing, or other related field. In lieu of degree, a minimum of 5 years of related work experience in healthcare industry.

  • Comprehensive understanding of interpreting laws, policies, regulations and the ability to apply these to programmatic action, research, and decisions.

·         A demonstrated ability to produce thorough research on a short time frame and the ability to work independently with minimal oversight.

·         Demonstrated exceptional analytical and writing capabilities.

Proficient in Microsoft Office Suites, including Excel, Outlook, SharePoint

Company Benefits

PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance. Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses. The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested. We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

EEO Commitment

It is company policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits, and termination, are made without regard to race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, citizenship status, veteran status, protected veteran status, disability, or any other characteristic protected by applicable federal, state, or local law.

Reasonable accommodations for applicants and employees with disabilities will be provided. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Human Resources by emailing HRDepartment@plan-sys.com, or by dialing 703-575-8400.

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