Billing & Enrollment Specialist

WPS—A health solutions companyFitchburg, WI
$20Remote

About The Position

Our Billing and Enrollment Specialist processes membership enrollment functions and assists in billing, cash posting, and ID card generation for new groups and members within our Health Plan. They enter and maintain all group and membership data in our enrollment system. This Billing and Enrollment Specialist provides support and answers questions or inquiries received from members, agents, and group leaders, relating to membership information to ensure administrative requirements are fulfilled and customer expectations are met.

Requirements

  • High School Diploma, GED or equivalent
  • 2 or more years of experience in health plan operations, enrollment, billing, or related healthcare field.
  • Proficient in billing and enrollment processes and procedures.
  • Excellent verbal and written communication and interpersonal skills.
  • Ability to work independently, be self-motivated and maintain positive relationships with customers and colleagues.
  • Strong organizational and problem-solving skills with proven attention to detail.

Nice To Haves

  • Ability to learn contract provisions regarding eligibility and termination.
  • Ability to learn and apply FACETS applications related to billing and enrollment.
  • Ability to accurately enter data.
  • Knowledge of eligibility and termination contract provisions.
  • Knowledge of state and federal eligibility and enrollment regulations.
  • Proficient knowledge of Microsoft Excel.

Responsibilities

  • Responding to written and phone inquiries from members, agents, and group leaders.
  • Verify, enter, and maintain all group level and member level contract data for new business including updating changes to demographic, premium, benefit, and status information.
  • Maintain awareness of underwriting guidelines, policy provisions, and product specifications as they pertain to customers.
  • Ensure accuracy and adherence of coverage for certified availability of coverages.
  • Process group cancellations and conduct final accounting reviews.
  • Perform collections of delinquent premium and termination for non-payment of premium.
  • Research and resolve eligibility discrepancies and errors; provide an explanation to customers to address the discrepancy or error.
  • Communicate and inform managers of issues that will require additional attention or procedure exceptions as needed to resolve a customer inquiry.

Benefits

  • Remote work options available
  • Performance bonus and/or merit increase opportunities
  • 401(k) with a 100% match for the first 3% of your salary and a 50% match for the next 2% of your salary (100% vested immediately)
  • Competitive paid time off
  • Health insurance, dental insurance, and telehealth services start DAY 1
  • Professional and Leadership Development Programs
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