Enrollment Specialist – MA (AFC)

Reporting to the Supervisor Enrollment the Enrollment Specialist for Adult Foster Care programs (AFC) are responsible for data quality control and contact with PCP and medical records offices to begin the enrollment process ensuring all required paperwork and authorizations are received in a timely manner to efficiently move care recipients into service. This individual will work directly with family caregivers referral partners and internal stakeholders to optimize the customer experience for new families coming into the program. This includes making recommendations on administrative and process improvements to relieve the administrative burden of referral partners and decrease the time it takes for families to gain access to Careforth services. This role will also manage relationships with external referral sources and PCP offices to enable efficient communication and document gathering and will oversee administrative efforts in an assigned territory.

Manage documentation retrieval process gathering required paperwork from caregivers care recipients referral sources and internal assessment teams to activate families into Careforth program(s); maintain and adhere to timelines in support of expedited service activation
Request medical records and physician order forms via fax and follow up phone calls from PCP and medical record offices

Manage the request and collection of prior authorization forms from payor sources and case managers tracking progress and making outreach as needed to expedite the authorization process
Perform eligibility and quality assurance checks and audits to ensure required documentation is in place and compliance standards are met
Works across multiple systems effectively and efficiently while adhering to Careforth service levels and quality standards
Foster positive and efficient working relationships with referral agencies and PCP offices to increase communication and referrals
Perform other projects and duties as assigned

2 years customer service or intake experience preferably in a health care environment
Strong attention to detail and experience with data integrity in a regulated environment
Strong written and verbal communication skills
Strong business acumen with desire to understand end-to-end business operations
Proficient with MS Office and demonstrated ability to work across multiple systems; Working knowledge of case management systems preferred

Able to work autonomously and as part of a larger team in a fast-paced remote environment

Knowledge of Massachusetts healthcare is highly desirable

At Careforth your well-being matters. With flexible schedules a remote-first culture and a nationally recognized wellness program our benefits are designed to help you thrive both professionally and personally. Discover how we invest in you: pay range for this position is$40000 - 53500. The actual wage offered may be lower or higher depending on budget and candidate experience knowledge skills qualifications and geographic location.

#LI-Remote (Role is remote; however we are unable to hire candidates residing California)