Eligibility Representative II

Centene

251d • $15 - $26

About The Position

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you'll have access to competitive benefits including a fresh perspective on workplace flexibility. Position Purpose: Processes and maintains eligibility information for routine individual and/or employer groups under general supervision. Maintains accurate eligibility records for individuals and/or assigned employer groups. Process all enrollments; plan changes, and disenrollment transactions. Reviews aging to determine delinquent accounts, membership reconciliation issues from premium issues. Produces and distributes delinquent notices to members. Provides daily support on incoming verbal or written correspondence enrollees regarding eligibility and processing status. Communicates policies, procedures and benefits to employees, enrolled members or, if applicable, employers. Interacts with staff in other departments to clarify and resolve eligibility problems presented by members. Provides cross training and back-up assistance to other enrollment groups. Provides support within service operations as needed such as Membership Accounting.

Requirements

• High School diploma or equivalent required.
• Two years general office work experience with attention to detail.
• One year previous experience in an HMO insurance or medical setting preferred.

Responsibilities

• Processes and maintains eligibility information for routine individual and/or employer groups under general supervision.
• Maintains accurate eligibility records for individuals and/or assigned employer groups.
• Processes all enrollments, plan changes, and disenrollment transactions.
• Reviews aging to determine delinquent accounts and membership reconciliation issues from premium issues.
• Produces and distributes delinquent notices to members.
• Provides daily support on incoming verbal or written correspondence from enrollees regarding eligibility and processing status.
• Communicates policies, procedures, and benefits to employees, enrolled members, or employers.
• Interacts with staff in other departments to clarify and resolve eligibility problems presented by members.
• Provides cross training and back-up assistance to other enrollment groups.
• Provides support within service operations as needed such as Membership Accounting.

Benefits

• Competitive pay
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field or office work schedules

What This Job Offers

• Career Level: Entry Level
• Industry: Ambulatory Health Care Services
• Education Level: High school or GED