Jenny Erstein
Franklin Square,NY
Summary
Highly Motivated, personable professional with extensive customer service in health care and a successful track record of profitable revenue and operational management experience
Overview
23
23
years of professional experience
Work History
Enrollment Data Analyst III
Anthem Blue Cross BlueShield
12.2017 - Current
- Conduct outreach to referred applicants upon receipt of referrals
- Answer inbound phone calls from perspective members inquiring about enrollment for Medicaid Advantage Plan and MLTC plan
- Pre determine applicant eligibility following Medicaid guidelines, verify ePaces and UAS assessments
- Communicate with Medicare Team on consumers interested in MAP plan
- Schedule initial assessments with field assessment nurses using Yellow Schedule
- Update enrollment team and UAS team on daily nurse availability
- Follow up with nurses on assessments and review enrollment documents, ensure signatures and dates are on all forms needed to process enrollment
- Ensure nurses upload all documents needed for enrollment in Care Compass
- Follow up efforts to ensure consumer enrollment are processed timely and accurately
- Document all follow ups with prospects in Care Compass and on Intake Log
- Handle enrollment documents received from prospects who did not decide on enrollment at time of assessment, upload them to Care Compass and process cases
- Conduct plan to plan warm transfers with Maximus prior to cut off date for enrollment once completed update warm transfer log
- Warm transfer consumers to Maximus to schedule Maximus assessments
- Maintain compliance while handling applicant/members information and or documentation
- Meet and or exceed company's performance metrics
- Handled Intake and Schedule reports
- Handle case assignments
- Team support train new staff on enrollment and scheduling process.
Intake and Enrollment Specialist
NORTH SHORE LIJ HEALTH PLAN
08.2014 - 10.2017
- Responsible for screening intake calls for Manage Long Term Care Enrollment
- Handle referrals from different home care agencies for client enrollment
- Verify personal information and demographics
- Enter and maintain accurate intake information in EMR system
- Verify ePACES for Medicaid eligibility, exemption and exclusion codes
- Follow up with nurse assessments for approval to submit enrollment to Medicaid
- Responsible for scheduling and sending nurses their daily scheduled assessments
- Conduct transfer calls if client is on another MLTC plan after approval
- Responsible for sending and updating all transfer forms to applicable agencies
- Triage client information in the Macess system
- Assist Supervisor with Medicaid reports for enrollment rejection errors
- Assist potential clients via conference calls with Medicaid to verify re-certification status
- Responsible for scheduling FIDA evaluations for new and existing members
- Scheduled and send authorization transportation requests for current members for Medical appointments
- Train new staff on enrollment process.
Revenue Analyst/Administrative Assistant
TRIUMPH HOTELS
09.2012 - 07.2014
- Provided revenue strategy support for 4 hotels representing $35mil in total hotel revenue
- Pre-opening support for an 800 room hotel
- Involved with providing strategic assessment to deliver tactical pull-through strategies
- Prepared Daily, Weekly, Quarterly and Yearly reports for Executive staff to assist in Inventory, Rates, and Customer Satisfaction to help achieve revenue objectives
- Daily monitored effectiveness of Revenue Control Plans
- Trained staff on new and current Revenue Control Policies and Protocols.
Reservations/Revenue Manager
BELLECLAIRE HOTEL
04.2002 - 08.2012
- Maximized room revenue on a daily, monthly and yearly basis
- Provided forecast reports to ownership with historical and current industry data
- Assisted the Sales and Marketing departments with new ideas on attracting more clientele
- Maintained distribution channel data integrity, conducted competitive and demand analysis
- Led a team of reservations agents, provided direction on revenue management, best practices, PMS Yield Systems and Third Party Channels
- Confirmed guarantee or non-guaranteed reservations, cleared waitlisted reservations
- Responsible for group entry of major airline as well billing
- Process all reservation requests, changes, and cancellations received by phone, fax, or mail.
Education
Applied Science in Toursim -
La Guardia Community College
07.1992
Skills
- Managed Care (9 years)
- Insurance Verification (9 years)
- Revenue Management
- ePaces
- HCS
- Yellow Schedule
- Care Compass
- Microsoft Office ( Word , Excel, Outlook)
Languages
Spanish
Native or Bilingual
Timeline
Enrollment Data Analyst III
Anthem Blue Cross BlueShield
12.2017 - Current
Intake and Enrollment Specialist
NORTH SHORE LIJ HEALTH PLAN
08.2014 - 10.2017
Revenue Analyst/Administrative Assistant
TRIUMPH HOTELS
09.2012 - 07.2014
Reservations/Revenue Manager
BELLECLAIRE HOTEL
04.2002 - 08.2012
Applied Science in Toursim -
La Guardia Community College
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