Eligibility Enrollment CSR/Processor

SOUTHWEST SERVICE ADMINISTRATORS INCTaylorsville, UT
$17 - $22Onsite

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
  • supplemental dental coverage of $1,000 per year for Employee
  • LONG TERM Disability & Life/AD&D coverage
  • 401K Plan including company match up to 5%
  • 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
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