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
New Hyde Park, NY
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
East Hills, NY
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
New York, NY
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
New York, NY
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