Eligibility Enrollment CSR/Processor

SOUTHWEST SERVICE ADMINISTRATORS INC • Taylorsville, UT

1d • $17 - $22

About The Position

The Enrollment & Eligibility CSR/Processor supports eligibility and enrollment functions, including member inquiries, enrollment processing, and related administrative responsibilities.

Requirements

• High School Diploma or equivalent
• Minimum 40 WPM and 3,000 KPH proficiency
• Ability to maintain current knowledge of all plan’s eligibility & enrollment rules to provide correct information to plan participants and providers.
• Ability to process enrollment and legal documents for all plans.
• Ability to verify provider credentials & update database.
• Ability to process appeals, write summaries, pursue approvals and overturn denials.
• Strong oral and written communication skills with exceptional attention to detail
• Professional, client-focused approach to colleagues and assignments.
• Ability to seek out experiences that may change perspective or provide an opportunity to learn new things.
• Strong dedication to follow-through on all tasks and assignments.
• Ability to sit for long periods of time operating a computer keyboard.

Responsibilities

• Process enrollment & legal documents for all plans
• Process appeals, write summaries, pursue approvals and overturn denials.
• Verify provider credentials and update the database.
• Handle incoming telephone calls and assist members with eligibility, enrollment, benefits, and plan-related inquiries in an efficient, prompt, and professional manner.
• Provide high quality customer service to all Fund members by documenting telephone, written and walk-in inquiries regarding benefits, or claim status.
• Respond to and resolve complex issues, including those escalated by members.
• Serve as primary, daily contact to clients on delivery of services.
• Resolve complex plan provision questions and issues addressed.
• Raise issues as appropriate to Team Supervisor or Department Manager.
• Learn and use professional excellence tools and concepts to ensure efficient and quality output/service delivery.
• Work cooperatively with other team members.
• Actively participate in team meetings and training activities.
• Perform additional responsibilities and projects as periodically assigned.

Benefits

• MEDICAL, DENTAL, VISION
• SHORT-TERM DISABILITY
• Full coverage benefits for a low weekly premium of $5 (Employee Only), $15 (for Child(ren) and $20 per week for full family or Employee/Spouse.
• COMPANY PAID supplemental dental coverage of $1,000 per year for Employee.
• COMPANY PAID LONG TERM Disability & Life/AD&D coverage.
• 401K Plan including company match up to 5%
• COMPANY PAID additional pension plan entirely funded by the company.
• EXCEPTIONAL TIME OFF package including Paid Personal Leave (PPL) and Vacation with annual BUY BACK options!!!!
• Annual, automatic pay increases.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees