Main Responsibilities and Required Skills for an Enrollment Specialist

An Enrollment Specialist is a professional who plays a pivotal role in facilitating the enrollment process for various educational institutions, healthcare organizations, and membership programs. They serve as the primary point of contact for individuals seeking information and assistance regarding enrollment procedures and requirements. In this blog post, we describe the primary responsibilities and the most in-demand hard and soft skills for Enrollment Specialists.

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Main Responsibilities of an Enrollment Specialist

The following list describes the typical responsibilities of an Enrollment Specialist:

Achieve

Achieve contact efficiency metrics and guide students through the online application process.

Address

Address and resolve inquiries, issues and concerns during implementations and terminations process.
Address concerns and complaints from applicants regarding enrollment processes.

Adhere to

Adhere to all company policies and procedures.
Adhere to the highest compliance standards.

Answer

Answer questions from Payer about eligibility and Payment conditions.

Arrange

Arrange and facilitates visits and tours for prospective students and their families.

Articulate

Articulate a warm and professional etiquette when speaking on the phone to patients.

Assist in

Assist customers (patients) with determining their eligibility for State Medicaid programs.
Assist individuals in completing enrollment forms and applications.
Assist in the development and implementation of organizational outreach and enrollment initiatives.
Assist in work related to website re-design and maintenance.
Assist new 401 (k) participants throughout the enrollment process.
Assist with enrollment-related documentation and paperwork.
Assist with enrollment-related financial transactions and fee payments.
Assist with enrollment-related technology systems and platforms.
Assist with financial aid and scholarship applications, if applicable.
Assist with indexing in the document management system.
Assist with large mail-outs for new clients or open enrollments.
Assist with Medicare and Medicaid enrollments, as needed.
Assist with timely ID card and packet generation.

Attach

Attach all relevant documents to patient profile.

Attend

Attend all department related meetings, trainings, and coaching.
Attend and successfully complete all required training programs.

Build

Build strong and sustainable relationships with clients and vendors.

Collaborate

Collaborate with marketing teams to develop enrollment materials and campaigns.
Collaborate with other departments to resolve enrollment-related issues.
Collaborate with our team members to improve enrollment processes.

Collect

Collect data utilizing various tracking tools that have been developed to monitor performance.

Communicate

Communicate effectively and timely with patients during their onboarding process.
Communicate effectively with peers, management, and clients.
Communicate status of patients POFs to healthcare providers.
Communicate with parents and answer questions about missing items required for enrollments.

Complete

Complete accurate data entry into multiple Federal, State and internal systems.
Complete all required corporate training within stated timelines to a satisfactory manner.
Complete forms for follow-up with other departments.
Complete other projects and duties as assigned.

Conduct

Conduct eligibility screenings to determine enrollment eligibility.
Conduct enrollment audits to ensure accuracy and compliance.
Conduct follow-up communication with enrolled individuals to ensure satisfaction.
Conduct outreach activities to promote enrollment opportunities.

Coordinate

Coordinate, completes, and follows-up on the revalidation process for contracted payers.
Coordinate correspondence to billing department to expedite provider number assignments.
Coordinate enrollment events and information sessions.
Coordinate tour requests and support admissions activities (open house, cougar start u, etc.).
Coordinate with academic advisors to assist with course selection and registration.
Coordinate with our team members about needed incomplete or outdated internal data.

Correspond with

Correspond with clients and carriers verbally and in writing.

Create

Create and Maintain CAQH profiles for providers.
Create and maintain proper tracking / workflow in the Provider Enrollment software application.

Determine

Determine the best delivery method based on the customer.
Determine what form of electronic payment the vendor will accept.

Develop

Develop strategies to streamline the enrollment process and improve efficiency.

Discuss

Discuss with Provider basic rules for billing of episodes.

Document

Document in Innovent IT systems.
Document issues worked on and resolved.

Educate

Educate potential clients on product focus.

Ensure

Ensure accurate and efficient data entry on a daily basis.
Ensure all required patient information is received to process the POF.
Ensure compliance with data protection and privacy regulations.
Ensure departmental guidelines support all contracted hospital privileges and procedures.
Ensure patient Protected Health Information (PHI) is entered and updated correctly.
Ensure positive customer experiences, both externally and internally.
Ensure registration is received and completed thoroughly and in a timely manner.

Enter

Enter and prioritize workflows necessary to complete participant enrollments.
Enter individual eligibility information to include new enrollments, changes and terminations.

Escalate

Escalate service issues as needed.

Follow

Follow established processes and procedures . ¿.
Follow policies and procedures when speaking with clients and vendors.
Follow specific contract requirements.
Follow up with applicants to obtain missing documentation or information.

Follow-up

Follow-up with submitted applications to make sure they are received and approved.

Foster

Foster new business relationships through inbound lead follow-up.

Generate

Generate, monitor, and follow up on EDI agreements meeting specific implementation deadlines.
Generate personal inquiries through network and professional relationships.

Guide

Guide prospective applicants through the enrollment process.

Handle

Handle an average of 35 calls per day (mix between sales and existing clients).
Handle inbound and outbound follow-up calls in a high-volume call center.
Handle special projects assigned by the manager.

Help

Help shape the future of healthcare in a meaningful career with a balanced life.

Identify

Identify and analyze the physician information received to ensure accuracy.
Identify customers' needs, clarifies information, researches every issue and provides solutions.

Interact

Interact with client employees / constituents as needed.

Investigate

Investigate issues and create solutions for new customers.

Log

Log information on calls received where required.

Maintain

Maintain accurate enrollment records and databases.
Maintain accurate interactions with prospective students in CRM.
Maintain a minimum standard of outbound and follow-up prospective students.
Maintain a professional appearance in accordance with the Denver Health Dress Code policy.
Maintain confidentiality and discretion when handling sensitive enrollment information.
Maintain current knowledge of College programs and services relevant to new and prospective students.
Maintain detailed and accurate records between multiple databases and programs.
Maintain files of correspondence, records and reports.
Maintain great customer service communications with providers and other departments.
Maintain patient confidentiality at all times.
Maintain regular and predictable attendance in accordance with the Denver Health Attendance policy.
Maintain strict confidentiality of all physician files.
Maintain up to date and accurate documentation of the account throughout the implementation process.
Maintain working knowledge of workflow, systems and tools used in the department.

Make

Make recommendations for process improvements.

Manage

Manage inbound and outbound telephone calls.
Manage incoming payments without a confirmed payment method.

Meet

Meet and maintain established department metrics for production and quality.
Meet personal and team qualitative and quantitative targets.

Monitor

Monitor enrollment trends and provide reports to management.

Navigate

Navigate through multiple IT systems.

Participate in

Participate in and complete performance assessments / evaluations as assigned.
Participate in ongoing conference calls, webinars, and other professional development opportunities.
Participate in professional development activities annually.
Participate in training sessions and professional development activities.
Participate on departmental and university committees.

Perform

Perform additional duties or job functions required and deemed necessary by supervisory personnel.
Perform administrative duties to assist the team in providing exceptional customer service.

Populate

Populate all data on Master Spreadsheet.
Populate all required information into the Payer Spreadsheets.

Prepare

Prepare departmental reports for manager.

Process

Process enrollment applications in a timely manner.
Process mass Primary Care Physician (PCP) changes with Provider Operations.
Process paper applications received for all applicable lines of business.
Process provider and facility enrollment and re-validation applications.
Process returned mail, making updates to the system as needed.

Promote

Promote a professional working relationship with internal and external customers.

Provide

Provide coaching / mentoring to staff on quality related items.
Provide detailed information about enrollment requirements and procedures.
Provide direct customer service to clients and / or their HR, Benefit & Payroll staff.
Provide enrollment and outreach services to client employees / constituents.
Provide excellent customer service to the providers and insurance payers.
Provide exceptional customer service.
Provide guidance and support to enrollment staff and team members.
Provide support during peak enrollment periods and registration deadlines.
Provide welcoming and friendly service to all customers, internal and external.

Receive

Receive and processes calls and emails to satisfy patient enrollment.
Receive and process Remote INR Patient Order Forms (POF) from healthcare providers.
Receive inbound calls from clinics or prescribers to answer any enrollment form questions.
Receive, process, and verify CHP+ enrollment fees and Medicaid Buy-In premium payments.

Recommend

Recommend educational goals and admission requirements to potential students.

Recruit

Recruit and utilize volunteers to increase program capacity.

Represent

Represent the organization at enrollment fairs, conferences, and community events.

Research

Research and resolve customer inquiries.
Research employee eligibility issues with client management staff.

Resolve

Resolve any customer requests in a timely and accurate manner.

Respond to

Respond to any deficiency notifications on behalf of the provider.
Respond to inquiries via phone, email, and in-person regarding enrollment-related matters.

Review

Review correspondence received from payor and providers and perform appropriate action to resolve.
Review data and documents for accuracy and missing required items.
Review enrollment applications for completeness and accuracy.
Review files and interpret the data to enter members into eligibility systems.
Review of Electronic Medical Records for active treatments and plan of care.

Serve

Serve clients in the not for profit, as well as the for-profit sectors.

Set-up

Set-up advising appointments.
Set-up and maintain provider information in an electronic database system.

Share successful education and process improvement ideas in a team environment.

Stay current with

Stay current with clinic locations, addresses, and contact information.
Stay updated on enrollment policies, regulations, and procedures.

Strive

Strive to develop and maintain partnerships between the College and its clients.

Support

Support and adheres to the Denver Health Code of Conduct.
Support application / registration events as applicable.

Track

Track license and certification expiration's for all providers to ensure timely renewals.

Transfer

Transfer patient profiles / information between FreseniusRx pharmacy locations.

Update

Update status of enrollment applications in database so other teams can access information.

Verify

Verify data in support of the eligibility determination.

Work

Work alongside the Student Registrar to ensure student records are correct.
Work independently and as a team member.
Work in multiple systems simultaneously.
Work with Analytics team regarding gathered data.
Work with client employees / constituents to resolve coverage and claim issues .
Work with clients and carriers in the resolution of enrollment or premium discrepancies.
Work with payors and providers to ensure compliance with enrollment and onboarding processes.

Most In-demand Hard Skills

The following list describes the most required technical skills of an Enrollment Specialist:

Proficiency in enrollment management software (e.g., Ellucian, Salesforce).
Knowledge of database management and data entry.
Familiarity with financial aid processes and systems.
Ability to navigate online enrollment portals and systems.
Skill in using Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
Experience with customer relationship management (CRM) software.
Understanding of enrollment reporting and analytics.
Knowledge of document management systems (e.g., DocuSign).
Proficiency in conducting online webinars and virtual enrollment events.
Familiarity with electronic document scanning and imaging technologies.
Ability to troubleshoot technical issues related to enrollment systems.
Skill in conducting online research and data analysis.
Understanding of student information systems (SIS) and registration modules.
Experience with electronic signature platforms for enrollment documentation.
Knowledge of electronic payment processing systems.
Ability to create and update enrollment forms and documents.
Experience with online learning management systems (LMS).
Skill in utilizing social media platforms for enrollment marketing.
Knowledge of cybersecurity protocols for protecting enrollment data.
Ability to learn and adapt to new enrollment technologies and software platforms.

Most In-demand Soft Skills

The following list describes the most required soft skills of an Enrollment Specialist:

Excellent communication skills, both verbal and written.
Empathy and patience when assisting applicants with enrollment inquiries.
Strong interpersonal skills for building rapport with prospective enrollees.
Attention to detail in reviewing and processing enrollment applications.
Problem-solving abilities to address enrollment-related issues and concerns.
Customer service orientation and a positive attitude.
Adaptability to changing enrollment procedures and requirements.
Time management skills to prioritize tasks and meet enrollment deadlines.
Ability to work collaboratively in a team-oriented environment.
Professionalism and integrity in handling confidential enrollment information.

Conclusion

Enrollment Specialists play a crucial role in facilitating access to educational and organizational opportunities. By possessing a blend of technical proficiency and soft skills, they contribute to ensuring a smooth and seamless enrollment experience for individuals seeking to pursue their academic or organizational goals.